Abstract Body (Do not enter title and authors here): Heart failure with preserved ejection fraction (HFpEF) prevalence has increased with the global increase in cardiometabolic risk factors and yet, diagnosis remains underrecognized in the community with concomitant undertreatment. H₂FpEF scoring is a validated tool for dyspnea evaluation but has potential to identify individuals with increased HFpEF risk in larger patient populations. Hispanics are known to have a high prevalence of cardiometabolic risk factors, specifically obesity, hypertension and diabetes, which predispose to HFpEF. As HFpEF is often considered a disease of the elderly, this study aimed to determine HFpEF risk and define demographic and clinical covariates associated with this risk, in community-dwelling young Hispanic adults.
Methods: Demographic, cardiometabolic biomarkers and echocardiographic data were obtained in 1285 participants (66% females, mean age 53±15 years) without any cardiovascular disease history from a sample of the Cameron County Hispanic Cohort. Those with left ventricular systolic dysfunction (n=30) were excluded. H₂FpEF scoring was performed, and the sample was divided into low risk (0-2 points) or intermediate-high risk (3-7 points). Analysis focused on those ≤60 years of age and multivariate logistic regression analyses were conducted.
Results: Intermediate-high risk H₂FpEF score was seen in 43% (n=555) of the sample. Among those ≤60 years of age (n=852, mean age 45±12 years), one third (33%) were at intermediate-high risk for HFpEF based on the H₂FpEF scoring tool. Those classified with increased HFpEF risk were slightly older (mean difference of 5 years), had larger waist circumference, had higher fasting blood glucose and more insulin resistance, and were more likely to have dyslipidemia, diabetes and the metabolic syndrome. After adjusting for covariates, among young Hispanics, age [OR=1.06 (1.01-1.11)] and the metabolic syndrome [OR=2.57 (1.06-6.36)] remained significantly associated with odds of having increased H₂FpEF score.
Discussion: We showed that a large proportion of community-dwelling Hispanics in our cohort have increased HFpEF risk, which is consistent with the demonstrated underdiagnosis of HFpEF in other ethnic groups. In young Hispanics, metabolic syndrome is significantly associated with a higher H₂FpEF score regardless of BMI. Defining elevated HFpEF risk in young adults may be relevant for prevention and early intervention, specifically targeting cardiometabolic risk control in young Hispanics.