One in four heart-failure cases in women might be preventable, health information from more than 230,000 female UK Biobank participants has revealed.
Summary
Data from more than 230,000 female UK Biobank participants suggest that women have a higher risk of heart failure if they have poor mental wellbeing, suffer socioeconomic deprivation or have a chronic inflammatory condition. These – potentially preventable – factors disproportionately affect women and are often overlooked in public-health campaigns.
Heart failure in women is largely preventable if we look beyond the usual causes like high blood pressure, says Peige Song from China’s Zhejiang University.
[The study] is a call to redefine prevention in women’s cardiovascular health, integrating biological, psychosocial and structural determinants into a unified, equitable approach.
Peige Song, Zhejiang University, China
Her team discovered that living in polluted areas, poor mental wellbeing, suffering socioeconomic deprivation and having chronic inflammatory conditions such as lupus make women more prone to heart failure. Yet these risks are often overlooked.
“[The study] is a call to redefine prevention in women’s cardiovascular health, integrating biological, psychosocial and structural determinants into a unified, equitable approach,” Song says.
Beyond well-known risks
Health information was analysed from more than 230,000 female UK Biobank participants.
Heart failure happens when the heart becomes too weak or stiff to properly pump blood around the body. Older people who have high blood pressure, diabetes, high cholesterol levels or who smoke are more likely to develop heart failure. “These are well-established and frequently targeted in public health and clinical strategies,” Song says.
Mental wellbeing, environment, socioeconomic circumstances and reproductive history rarely get the same attention. And some of these risks disproportionately affect women, Song explains: “For instance, depression is more prevalent in women, and often underdiagnosed, and socioeconomic constraints uniquely affect women’s ability to access care.”
Health information from more than 230,000 female UK Biobank participants has revealed that these factors combined pose nearly as much risk as all of the well-known risks taken together. Socioeconomic hardship and chronic inflammatory conditions such as lupus or rheumatoid arthritis stood out as particularly detrimental.
“One in four heart-failure cases in women could be prevented if all under-recognised risk factors were eliminated, assuming causal relationships,” Song says. While completely eliminating all risks isn’t realistic, she adds, “even partial reductions – through better mental health services, social equity policies and environmental regulations – could yield significant public health benefits”.
Gender-sensitive care is key
These calculations show convincingly that under-recognised and female-specific risk factors contribute significantly to heart failure in women, independently of the well-established ones.
Professor Catherine Pirkle, University of Hawaiʻi, US
“These calculations show convincingly that under-recognised and female-specific risk factors contribute significantly to heart failure in women, independently of the well-established ones,” says women’s health specialist Catherine Pirkle of the University of Hawaiʻi at Mānoa in the US.
However, the study missed links between certain risk factors, Pirkle points out. For example, reducing socioeconomic deprivation might also reduce the number of people who develop high blood pressure, which is one of the key drivers of heart failure.
“It’s important to understand that heart health is influenced by more than just blood pressure or cholesterol,” Song concludes. “Factors like mental wellbeing, reproductive milestones and socioeconomic conditions all matter. Awareness and advocacy for comprehensive, gender-sensitive care are key.”
