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Heart failure risk might depend on your neighborhood

The risk of developing heart failure is highly dependent on diet, lifestyle, and genetics. A new study, however, suggests that where we live may also play a key role.
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Researchers suggest that our neighborhoods play a role in our risk of heart failure.

Researchers discovered that people who lived in deprived areas were more likely to develop heart failure than individuls who resided in wealthier areas.

Co-senior study author Dr. Elvis Akwo, who is a postdoctoral research fellow from Vanderbilt University Medical Center in Nashville, TN, and colleagues note that previous research has shown that a person's individual socioeconomic status can have negative health implications.

But the team says that this new study shows that the socioeconomic status of one's neighborhood can also affect heart failure risk.

The researchers recently published their findings in the journal Circulation: Cardiovascular Quality and Outcome.

Heart failure occurs when the heart is no longer able to pump enough oxygen-rich blood to aid the functioning of other organs. According to the Centers for Disease Control and Prevention (CDC), it affects around 5.7 million adults in the United States.

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While there is currently no cure for heart failure, lifestyle changes, medications, and surgery are some of the treatments that can help to prolong survival. Still, around 50 percent of people with heart failure die within 5 years of being diagnosed.

As such, it is important to identify all risk factors for heart failure, as this guides us toward strategies that can help to prevent the condition.

From their study, Dr. Akwo and his colleagues believe that they have identified a person's place of residence as a risk factor for heart failure.

In order to reach their findings, the researchers analyzed the data of 27,078 adults aged 40–79. All subjects were part of the Southern Community Cohort Study, which is a health study of adults across 12 states in southeastern America, between 2002 and 2009.

Around 69 percent of the participants were African-American, and around 63 percent were women.

The team divided the subjects into three groups, ranging from those who lived the least-deprived neighborhoods to those who lived in the most deprived.

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Highest heart failure incidence in poor areas

Subjects were followed-up for a median of 5.2 years. During this time, a total of 4,300 participants developed heart failure.

The researchers found that adults who lived in the most deprived areas had the highest incidence of heart failure, at 37.9 per 1,000 person-years, compared with 28.4 per 1,000 person-years for those who lived in the least-deprived areas.

After adjusting for participants' age, sex, race, and lifestyle and clinical factors, the scientists found that each tier jump in neighborhood deprivation — from the least deprived to the most deprived — was associated with a 12 percent increase in heart failure risk.

Overall — after further adjustment for subjects' education and income — the team calculated that a person's place of residence accounted for 4.8 percent of their heart failure risk.

"There is existing evidence," notes co-senior study author Loren Lipworth, an associate professor of epidemiology at Vanderbilt University Medical Center, "suggesting strong, independent associations between personal socioeconomic status — like education, income level, and occupation — and risks of heart failure and many other chronic diseases."

"But what this study adds," she explains, "is evidence suggesting that characteristics of your place of residence, actually also play a significant role in influencing the risk of heart failure over and above the role of your own individual socioeconomic characteristics."

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Neighborhood 'predicts risk of heart failure'

The researchers note that because their study mainly focused on middle-aged individuals with low income, the results cannot be generalized to other populations just yet.

Still, they hope that their results will encourage community-based interventions that can help individuals to reduce their risk of heart failure.

"Public policy professionals need to pay attention to the neighborhood, not just the individuals, because your place of residence does predict your risk of heart failure. Improved community-level resources may ultimately reduce the risk of heart failure in these communities."

Dr. Elvis Akwo

"These are merely suggestions on what could have some impact," Dr. Akwo goes on to explain. "We hope that our study will open the door for experimental studies for interventions and what kinds of measures can be tested to improve the cardiovascular health of entire communities," instead of, he says, "just one person at a time."

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