Abnormal Cholesterol Raises Heart Failure Risk


Abnormal levels of cholesterol have long been associated with an increased risk of heart attacks and stroke, and now you can add heart failure to the list. Results of a new study show, among other findings, that the risk of heart failure is 29 percent higher in individuals who have high LDL (low-density lipoprotein) cholesterol and triglyceride levels than those who have lower levels.

Heart failure, also known as congestive heart failure, is a condition in which the heart is unable to pump a sufficient amount of blood to meet the body’s needs. An estimated 5.7 million Americans have heart failure and experience its symptoms of fatigue, shortness of breath, swelling of the ankles and lower legs, heart palpitations, and cognitive difficulties. The most significant risk factor for heart failure is high blood pressure, while others include coronary artery disease (characterized by narrowed arteries), heart attack, diabetes, and irregular heartbeat.

This latest study, which was led by Dr. Daniel Levy of the National Heart, Lung and Blood Institute, evaluated data from 6,860 individuals who had participated in the Framingham Heart Study and who were free of heart disease when they entered the study. All of the subjects were followed for an average of 26 years.


Dr. Levy and his team found that 680 of the participants had developed heart failure. When the researchers analyzed the data for these patients, they found that 12.8 percent of them had low levels of high-density lipoprotein (HDL) cholesterol (the “good” cholesterol), and only 6.1 percent had desirable levels (defined as 55 mg/dL or greater in men and 65 mg/dL or greater in women). Levels of LDL cholesterol (“bad” cholesterol) and triglycerides were high in 13.8 percent of the patients and desirable (less than 160 mg/dL) in only 7.9 percent.

After the investigators made adjustments for age, sex, body weight, smoking, blood pressure, diabetes, and other factors, they found that patients who had high levels of LDL had a 29 percent greater risk of experiencing heart failure, while patients who had high levels of HDL had a 40 percent reduced risk of heart failure. When heart attacks were factored in, the scientists found that high cholesterol levels were still associated with a statistically significant risk of heart failure.

The results of this study suggest that improving cholesterol levels through use of cholesterol-lowering drugs (mostly statins), instituting dietary changes, getting regular exercise, stopping smoking, and limiting intake of alcohol can not only help prevent heart attack and stroke but heart failure as well.

American Heart Association
Mayo Clinic
Velagaleti RS et al. Circulation 2009 Nov. 23 pub. before print