Heart failure | Pomegranate

Metadata

Name	Heart failure (hf)
Category	Cardiovascular
Sex
Adult	Yes
UUID	078c47bf-92d3-45de-83ae-25bf52cee751
Definition	Inability of the heart to pump blood at an adequate rate to meet tissue metabolic requirements. Clinical symptoms of heart failure include unusual dyspnea on light exertion, recurrent dyspnea occurring in the supine position, fluid retention or rales, jugular venous distension, pulmonary edema on physical exam, or pulmonary edema on chest x-ray presumed to be cardiac dysfunction.

Ontologies

Disease Ontology (DOID)	DOID_9651
GWAS Catalogue	EFO_1001207
MeSH	D006333
SNOMED-CT	417996009
FinnGen	I9_HEARTFAIL

Key Summary Statistics

Cases from any source

Total	17761
Female (%)	6236 (35%)
Male (%)	11525 (65%)

Year first recorded

hf year of first event

Cases linked in all UK Biobank sources

Cross-source concordance

Vertical bars correspond to number of cases per source/intersection; horizontal bars to left correspond to total number of cases per source.

Cross-sourced hf cases

Incidence & prevalence

Sex and age-stratified incidence and prevalence of hf

Baseline prevalence stratified by sex

Female	41.37 (37.06,45.69)
Male	142.51 (133.82,151.21)

Incidence stratified by sex

Female	10.48 (9.64,11.33)
Male	26.69 (25.2,28.17)

Incidence stratified by age

Ages 40-44	2.42 (1.45,3.38)
Ages 45-49	4.61 (3.46,5.76)
Ages 50-54	9.1 (7.61,10.6)
Ages 55-59	13.7 (12.04,15.36)
Ages 60-64	22.23 (20.4,24.05)
Ages 65-69	40.09 (37.27,42.91)

Period prevalence

Methods

Comparison with general population

Sex-standardised prevalence from CALIBER study (Kuan et al. 2019)

CALIBER and UKB hf prevalence comparison for multiple age groups

Population	Ages 40-49	Ages 50-59	Ages 60-69
UK Biobank	41 (35,48)	111 (103,120)	304 (292,316)
CALIBER	45 (43,46)	133 (130,136)	362 (355,368)

Stratified by age and Townsend deprivation status

Deprivation status	Ages 40-49	Ages 50-59	Ages 60-69
Least deprived	18(10,31)	76(61,93)	221(200,243)
Low	29(17,45)	76(61,93)	275(251,299)
Medium	28(17,42)	100(83,120)	278(254,304)
High	43(30,59)	128(109,150)	295(270,323)
Most deprived	72(57,91)	171(149,195)	483(449,519)

Stratified by age and country

Country	Ages 40-49	Ages 50-59	Ages 60-69
England	40(33,48)	110(100,119)	301(288,314)
Scotland	39(23,61)	121(98,147)	292(259,327)
Wales	62(37,98)	110(82,143)	355(311,403)

Risk factors analysis

‘Healthy’ BMI, smoking status ‘never’, or no hypertension (absence of hypertension records) were considered as reference values.

Hazard Ratio (HR) values with P < 0.0002 were considered to show significant association with disease onset after correction for multiple-testing using the Bonferroni method

N=153996, Events=147

Factor	Level	Hazard Ratio	P value
BMI	overweight	0.93 (0.63, 1.37)	0.695
BMI	obese	1 (0.64, 1.55)	0.987
BMI	underweight	0 (0, Inf)	0.994
smoking	previous	1.24 (0.87, 1.76)	0.231
smoking	current	1.53 (0.9, 2.59)	0.116
hypertension	yes	1.65 (1.18, 2.3)	0.00322

Risk factors analysis forest plot

Definition

UK Biobank field id	Description	Code	Value
20002	Non-cancer illness code, self-reported	1076	heart failure/pulmonary odema
41202	Diagnoses - main ICD10	I11.0	Hypertensive heart disease with (congestive) heart failure
41202	Diagnoses - main ICD10	I13.0	Hypertensive heart and renal disease with (congestive) heart failure
41202	Diagnoses - main ICD10	I13.2	Hypertensive heart and renal disease with both (congestive) heart failure and renal failure
41202	Diagnoses - main ICD10	I50	Heart failure
41204	Diagnoses - secondary ICD10	I11.0	Hypertensive heart disease with (congestive) heart failure
41204	Diagnoses - secondary ICD10	I13.0	Hypertensive heart and renal disease with (congestive) heart failure
41204	Diagnoses - secondary ICD10	I13.2	Hypertensive heart and renal disease with both (congestive) heart failure and renal failure
41204	Diagnoses - secondary ICD10	I50	Heart failure
40001	Underlying (primary) cause of death: ICD10	I11.0	Hypertensive heart disease with (congestive) heart failure
40001	Underlying (primary) cause of death: ICD10	I13.0	Hypertensive heart and renal disease with (congestive) heart failure
40001	Underlying (primary) cause of death: ICD10	I13.2	Hypertensive heart and renal disease with both (congestive) heart failure and renal failure
40001	Underlying (primary) cause of death: ICD10	I50	Heart failure
40002	Contributory (secondary) causes of death: ICD10	I11.0	Hypertensive heart disease with (congestive) heart failure
40002	Contributory (secondary) causes of death: ICD10	I13.0	Hypertensive heart and renal disease with (congestive) heart failure
40002	Contributory (secondary) causes of death: ICD10	I13.2	Hypertensive heart and renal disease with both (congestive) heart failure and renal failure
40002	Contributory (secondary) causes of death: ICD10	I50	Heart failure
42040	GP clinical event records	14A6.00	H/O: heart failure
42040	GP clinical event records	14AM.00	H/O: Heart failure in last year
42040	GP clinical event records	1O1..00	Heart failure confirmed
42040	GP clinical event records	388D.00	New York Heart Assoc classification heart failure symptoms
42040	GP clinical event records	661M500	Heart failure self-management plan agreed
42040	GP clinical event records	662f.00	New York Heart Association classification - class I
42040	GP clinical event records	662g.00	New York Heart Association classification - class II
42040	GP clinical event records	662h.00	New York Heart Association classification - class III
42040	GP clinical event records	662i.00	New York Heart Association classification - class IV
42040	GP clinical event records	662p.00	Heart failure 6 month review
42040	GP clinical event records	662T.00	Congestive heart failure monitoring
42040	GP clinical event records	662W.00	Heart failure annual review
42040	GP clinical event records	679W100	Education about deteriorating heart failure
42040	GP clinical event records	679X.00	Heart failure education
42040	GP clinical event records	8B29.00	Cardiac failure therapy
42040	GP clinical event records	8CeC.00	Preferred place of care for next exacerbation heart failure
42040	GP clinical event records	8CL3.00	Heart failure care plan discussed with patient
42040	GP clinical event records	8CMK.00	Has heart failure management plan
42040	GP clinical event records	8CMW800	Heart failure clinical pathway
42040	GP clinical event records	8H2S.00	Admit heart failure emergency
42040	GP clinical event records	8HBE.00	Heart failure follow-up
42040	GP clinical event records	8HHz.00	Referral to heart failure exercise programme
42040	GP clinical event records	8Hk0.00	Referred to heart failure education group
42040	GP clinical event records	9h11.00	Excepted from LVD quality indicators: Patient unsuitable
42040	GP clinical event records	9h12.00	Excepted from LVD quality indicators: Informed dissent
42040	GP clinical event records	9h1..00	Exception reporting: LVD quality indicators
42040	GP clinical event records	9hH0.00	Excepted heart failure quality indicators: Patient unsuitabl
42040	GP clinical event records	9hH1.00	Excepted heart failure quality indicators: Informed dissent
42040	GP clinical event records	9hH..00	Exception reporting: heart failure quality indicators
42040	GP clinical event records	9N2p.00	Seen by community heart failure nurse
42040	GP clinical event records	9N6T.00	Referred by heart failure nurse specialist
42040	GP clinical event records	9On0.00	Left ventricular dysfunction monitoring first letter
42040	GP clinical event records	9On1.00	Left ventricular dysfunction monitoring second letter
42040	GP clinical event records	9On2.00	Left ventricular dysfunction monitoring third letter
42040	GP clinical event records	9On3.00	Left ventricular dysfunction monitoring verbal invite
42040	GP clinical event records	9On4.00	Left ventricular dysfunction monitoring telephone invite
42040	GP clinical event records	9On..00	Left ventricular dysfunction monitoring administration
42040	GP clinical event records	9Or0.00	Heart failure review completed
42040	GP clinical event records	9Or1.00	Heart failure monitoring telephone invite
42040	GP clinical event records	9Or2.00	Heart failure monitoring verbal invite
42040	GP clinical event records	9Or3.00	Heart failure monitoring first letter
42040	GP clinical event records	9Or4.00	Heart failure monitoring second letter
42040	GP clinical event records	9Or5.00	Heart failure monitoring third letter
42040	GP clinical event records	9Or..00	Heart failure monitoring administration
42040	GP clinical event records	G1yz100	Rheumatic left ventricular failure
42040	GP clinical event records	G210100	Malignant hypertensive heart disease with CCF
42040	GP clinical event records	G211100	Benign hypertensive heart disease with CCF
42040	GP clinical event records	G21z100	Hypertensive heart disease NOS with CCF
42040	GP clinical event records	G232.00	Hypertensive heart&renal dis wth (congestive) heart failure
42040	GP clinical event records	G234.00	Hyperten heart&renal dis+both(congestv)heart and renal fail
42040	GP clinical event records	G400.00	Acute cor pulmonale
42040	GP clinical event records	G41z.11	Chronic cor pulmonale
42040	GP clinical event records	G554000	Congestive cardiomyopathy
42040	GP clinical event records	G554011	Congestive obstructive cardiomyopathy
42040	GP clinical event records	G580000	Acute congestive heart failure
42040	GP clinical event records	G580100	Chronic congestive heart failure
42040	GP clinical event records	G580200	Decompensated cardiac failure
42040	GP clinical event records	G580300	Compensated cardiac failure
42040	GP clinical event records	G580400	Congestive heart failure due to valvular disease
42040	GP clinical event records	G580.00	Congestive heart failure
42040	GP clinical event records	G580.11	Congestive cardiac failure
42040	GP clinical event records	G580.12	Right heart failure
42040	GP clinical event records	G580.13	Right ventricular failure
42040	GP clinical event records	G580.14	Biventricular failure
42040	GP clinical event records	G581000	Acute left ventricular failure
42040	GP clinical event records	G581.00	Left ventricular failure
42040	GP clinical event records	G581.11	Asthma - cardiac
42040	GP clinical event records	G581.13	Impaired left ventricular function
42040	GP clinical event records	G582.00	Acute heart failure
42040	GP clinical event records	G584.00	Right ventricular failure
42040	GP clinical event records	G58..00	Heart failure
42040	GP clinical event records	G58..11	Cardiac failure
42040	GP clinical event records	G58z.00	Heart failure NOS
42040	GP clinical event records	G58z.12	Cardiac failure NOS
42040	GP clinical event records	G5yy900	Left ventricular systolic dysfunction
42040	GP clinical event records	G5yyA00	Left ventricular diastolic dysfunction
42040	GP clinical event records	ZRad.00	New York Heart Assoc classification heart failure symptoms
42040	GP clinical event records	XaK6W	Left ventricular dysfunction monitoring administration
42040	GP clinical event records	XaKNa	Seen by community heart failure nurse
42040	GP clinical event records	XaJ4Y	Excepted from LVD quality indicators: Patient unsuitable
42040	GP clinical event records	XaMGt	Heart failure monitoring second letter
42040	GP clinical event records	XaKNW	Admit heart failure emergency
42040	GP clinical event records	XaIpn	Heart failure confirmed
42040	GP clinical event records	XaIQN	Heart failure annual review
42040	GP clinical event records	XaBLt	Cardiac failure therapy
42040	GP clinical event records	XaK6Z	Left ventricular dysfunction monitoring second letter
42040	GP clinical event records	XaK6a	Left ventricular dysfunction monitoring third letter
42040	GP clinical event records	XaJ9I	New York Heart Association classification - class III
42040	GP clinical event records	XaO5n	Congestive heart failure due to valvular disease
42040	GP clinical event records	XaIIU	Congestive heart failure monitoring
42040	GP clinical event records	XaYbC	Heart failure self-management plan agreed
42040	GP clinical event records	XaKc0	Left ventricular dysfunction monitoring verbal invite
42040	GP clinical event records	XaJ9G	New York Heart Association classification - class I
42040	GP clinical event records	XaJ4Z	Excepted from LVD quality indicators: Informed dissent
42040	GP clinical event records	XaXzw	Preferred place of care for next exacerbation of heart failure
42040	GP clinical event records	X202l	Right ventricular failure
42040	GP clinical event records	XE0V9	Heart failure NOS
42040	GP clinical event records	XaMJ9	Exception reporting: heart failure quality indicators
42040	GP clinical event records	XaMFr	Heart failure monitoring telephone invite
42040	GP clinical event records	XaLN7	Heart failure review completed
42040	GP clinical event records	XaXkR	Has heart failure management plan
42040	GP clinical event records	XaJ4N	Exception reporting: LVD quality indicators
42040	GP clinical event records	XaIIq	Left ventricular systolic dysfunction
42040	GP clinical event records	XaYft	Education about deteriorating heart failure
42040	GP clinical event records	XaJ9H	New York Heart Association classification - class II
42040	GP clinical event records	XaIQM	Heart failure follow-up
42040	GP clinical event records	XaK6Y	Left ventricular dysfunction monitoring first letter
42040	GP clinical event records	XaMGm	Left ventricular dysfunction monitoring telephone invite
42040	GP clinical event records	XE0Un	Chronic pulmonary heart disease NOS
42040	GP clinical event records	XaNUf	Heart failure education
42040	GP clinical event records	XE0Uz	Congestive cardiomyopathy
42040	GP clinical event records	XaMJB	Excepted from heart failure quality indicators: Informed dissent
42040	GP clinical event records	XaLNA	Heart failure care plan discussed with patient
42040	GP clinical event records	XaBwi	H/O: Heart failure in last year
42040	GP clinical event records	XaMGu	Heart failure monitoring third letter
42040	GP clinical event records	XaMGs	Heart failure monitoring first letter
42040	GP clinical event records	XaIL7	New York Heart Association classification of heart failure symptoms
42040	GP clinical event records	XaJ9J	New York Heart Association classification - class IV
42040	GP clinical event records	XaMGo	Heart failure monitoring verbal invite
42040	GP clinical event records	XaMJA	Excepted from heart failure quality indicators: Patient unsuitable
42040	GP clinical event records	XaLMx	Referral to heart failure exercise programme
42040	GP clinical event records	XaItG	Left ventricular diastolic dysfunction
42040	GP clinical event records	XaLSI	Referred to heart failure education group
42040	GP clinical event records	XE2QG	Left ventricular failure
42040	GP clinical event records	XE2QG	Left ventricular failure
42040	GP clinical event records	XaZih	Heart failure clinical pathway
42040	GP clinical event records	XaLN6	Heart failure monitoring administration
42040	GP clinical event records	XaLon	Heart failure 6 month review
42040	GP clinical event records	XaLCj	Referred by heart failure nurse specialist