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Original research
Comparison of incidence rates and risk factors of heart failure between two male cohorts born 30 years apart
  1. Constantinos Ergatoudes1,2,
  2. Per-Olof Hansson1,2,
  3. Kurt Svärdsudd3,
  4. Annika Rosengren1,2,
  5. Erik Östgärd Thunström1,2,
  6. Kenneth Caidahl4,
  7. Aldina Pivodic5,6,
  8. Michael Fu1,2
  1. 1 Sahlgrenska Universitetssjukhuset Ostra Sjukhuset, Goteborg, Sweden
  2. 2 Department of Molecular and Clinical Medicine/Emergency and Cardiovascular Medicine Cardiology, Sahlgrenska Academy, Gothenburg, Sweden
  3. 3 Uppsala University, Uppsala, Sweden
  4. 4 Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
  5. 5 Statistiska Konsultgruppen, Gothenburg, Sweden
  6. 6 Sahlgrenska Academy, Goteborg, Sweden
  1. Correspondence to Dr Constantinos Ergatoudes, Sahlgrenska Academy, Goteborg 405 30, Sweden; constantinos.ergatoudes{at}


Objective To compare two cohorts of middle-aged men from the general population born 30 years apart for incidence and predictors of heart failure (HF).

Methods Two population samples of men, born in 1913 (n=855) and in 1943 (n=797), were examined at 50 years of age and followed up for 21 years (1963–1994 and 1993–2014). Cox regression analysis was used to examine the impact of different factors on the risk of developing HF.

Results Eighty men born in 1913 (9.4%) and 42 men born in 1943 (5.3%) developed HF during follow-up; adjusted HRs comparing the two cohorts (born 1943 vs 1913) were: 0.46 (95% CI 0.28 to 0.74, p=0.002). In both cohorts, higher body mass index, higher diastolic blood pressure, treatment for hypertension, onset of either atrial fibrillation (AF), ischaemic heart disease and diabetes mellitus were associated with higher risk of HF. Higher heart rate was associated with an increased risk only in men born in 1913, whereas higher systolic blood pressure (SBP), smoking, higher glucose, higher cholesterol and physical inactivity were associated with an increased risk in men born in 1943. AF contributed higher risk of incident HF, whereas SBP and physical inactivity contributed lower risk in men born in 1943 compared with men born in 1913.

Conclusions Men born in 1943 had half the risk of HF after their 50s than those born 30 years earlier. AF, obesity, ischaemic heart disease, diabetes and hypertension remain important precursors of HF.

  • heart failure
  • cardiac risk factors and prevention

Statistics from


  • Contributors CE, P-OH, KS, AR and MF contributed to the conception and the design of the work. CE, EOT, KS, KC collected the data. CE and AP analysed the data. CE drafted the article. P-OH, KS, AR, EOT, CK, AP and MF revised the article critically for important intellectual content. All authors gave the final approval and agreed to be accountable for all aspects of work, ensuring integrity and accuracy.

  • Funding This study was supported by grants from the Region Västra Götaland agreement concerning research and education of doctors (ALFGBG-508831, MF; ALFGBG-140341, 447561,726481,824851, KC; ALFGBG-717211, AR), the Health and Medical Care Committee of the Regional Executive Board, Region Västra Götaland (VGFOUREG- 564181) (MF), the Swedish Research Council (grant number 2013-5187 (SIMSAM), 2013-4236, K2012-65X-22036-01-3) and the Swedish Heart and Lung Foundation.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval The study complied with the Declaration of Helsinki, except for the screening examination in 1963 where only oral informed consent was given. The study protocol was approved by the ethics committee of Gothenburg University (DNR 157‐93, 0067‐03 and DNR 649‐13).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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