SynthesisBMJ open2025
Comorbidities and incidence of heart failure with preserved ejection fraction: a systematic review and meta-analysis of cohort studies.
Synthesis in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Heart Failure with Preserved Ejection Fraction in Women: Sex-Specific Insights Across the Continuum from Diagnosis to Outcomes.Current cardiology reports · 2026Review
- MicroRNAs in Heart Failure Pathogenesis and Progression: Mechanistic Control, Biomarker Potential, and Translational Perspectives.Life (Basel, Switzerland) · 2026Review
- The Adipokine Axis in Heart Failure: Linking Obesity, Sarcopenia and Cardiac Dysfunction in HFpEF.International journal of molecular sciences · 2026Review
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo identify comorbidities associated with incident heart failure with preserved ejection fraction (HFpEF) and quantify their HRs for early risk stratification and prevention.
designPROSPERO-registered (CRD42024505533) systematic review and meta-analysis. Primary analysis prioritised unadjusted HRs; exploratory analysis incorporated adjusted HRs. DATA SOURCES: Ovid MEDLINE, Embase and the Cochrane Central Register of Controlled Trials through 15 June 2025. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Cohort studies of adults (≥18 years) without prior HF reporting HRs for incident HFpEF-associated comorbidities. EXCLUSIONS: non-English publications, reviews, non-clinical studies and studies without HR data. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently extracted data and assessed quality (Newcastle-Ottawa Scale). Random-effects models pooled HRs. Heterogeneity was investigated using Galbraith/Baujat plots, meta-regression and subgroup analyses. Publication bias assessed via funnel plots, Egger's and Begg's tests.
resultsAmong 61 eligible studies, 22 reporting unadjusted HRs formed the primary analysis, identifying five comorbidities with significant incident HFpEF risk: atrial fibrillation (AF) (HR 2.92, 95% CI 1.94 to 4.37, I²=86.6%), hypertension (HR 2.28, 95% CI 1.35 to 3.84, I²=96.9%), diabetes (HR 1.88, 95% CI 1.54 to 2.30, I²=58.2%), obesity (HR 1.70, 95% CI 1.45 to 2.00, I²=69.7%) and myocardial infarction (MI) (HR 1.62, 95% CI 1.18 to 2.23, I²=72.1%). Conversely, chronic kidney disease (CKD) (HR 1.44, 95% CI 0.68 to 3.06, I²=86.6%) and cerebrovascular disease (HR 1.72, 95% CI 0.93 to 3.18, I²=77.2%) showed non-significant associations. Exploratory analysis integrating unadjusted HRs from primary studies and adjusted HRs from 39 additional studies confirmed these five comorbidities as significant risk factors, with CKD again demonstrating non-significant association.
conclusionAF, hypertension, diabetes, obesity and MI constitute evidence-based targets for HFpEF risk stratification and preventive management. The CKD-HFpEF association requires validation in larger cohorts. PROSPERO REGISTRATION NUMBER: CRD42024505533.
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