Diabetes can independently lead to heart failure, Mayo Clinic study finds

A new study by the Mayo Clinic in Rochester, Minnesota, examines the idea of diabetic cardiomyopathy and heart failure from the effects of diabetes alone.

Heart problems are a common development for people with diabetes. About 33 percent of people in the U.S. admitted to the hospital for heart failure also have diabetes. Heart failure may be the result of a co-condition, such as hypertension or coronary heart disease, but not always.

Using the Rochester Epidemiology Project, researchers led by Horng Chen, MD, a cardiologist at the Mayo Clinic, evaluated the long-term impact of diabetes on the development of heart failure, both with preserved ejection fraction, a measurement of the percentage of blood leaving the heart with each contraction, and reduced ejection fraction. They also looked at mortality in a community population, controlling for hypertension, coronary artery disease and diastolic function.

From an initial group of 2,042 residents of Olmsted County, 116 study participants with diabetes were matched 1:2 for age, hypertension, sex, coronary artery disease, and diastolic dysfunction to 232 participants without diabetes. Over the 10-year follow-up period, 21 percent of participants with diabetes developed heart failure, independent of other causes. In comparison, only 12 percent of patients without diabetes developed heart failure. Cardiac death, heart attack, and stroke were not statistically different in the study between the two groups.

The study shows that diabetes is an independent risk factor for the development of heart failure in the community dwelling population. Furthermore, the outcome data support the concept of a diabetic cardiomyopathy.

This research extends previous findings and demonstrates that even without a known cardiac structural abnormality and with a normal ejection fraction, diabetic patients are still at increased risk of developing heart failure as compared to their nondiabetic counterparts.

"The key takeaway is that diabetes mellitus alone is an independent risk factor for the development of heart failure," said Chen in a statement. "Our hope is that this study provides a strong foundation for further investigations into diabetes and heart failure. There is still much to learn and study in terms of this association and how to best diagnose and treat this condition."