Observational studyGeroScience2026
Leukocyte telomere length and risk of heart failure with preserved ejection fraction in high-risk Chinese patients with hypertension under 65 years.
Observational study in GeroScience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Shorter leukocyte telomere length (LTL) is associated with aging-related cardiovascular diseases, but its relationship with heart failure with preserved ejection fraction (HFpEF) in high-risk Chinese patients with hypertension under 65 years remains unclear. In this observational prospective study, we investigated 646 patients with hypertension aged < 65 years with diabetes, coronary heart disease (CHD), or ≥ 3 cardiovascular risk factors. Baseline assessments included clinical evaluation, measurement of aging markers (LTL and mitochondrial DNA copy number) and echocardiography. Participants underwent scheduled quarterly follow-up for 5 years, with documentation of major adverse cardiovascular events (MACEs), including cardiovascular mortality, myocardial infarction, ischemia-driven revascularization, stroke and heart failure hospitalization. At the final follow-up visit, the evaluation for HFpEF was performed through echocardiography and plasma B-type natriuretic peptide (BNP) measurement. Participants were stratified by LTL tertiles: long (> 79.89; n = 216), mid (58.49-79.89; n = 214), and short (< 58.49; n = 216). Compared with the long and mid LTL groups, the short LTL group had a higher prevalence of male, smoking, hyperlipidemia, diabetes, and CHD, along with elevated blood pressure and fasting blood glucose, but lower mitochondrial DNA copy number (all P < 0.05). At 5-year follow-up, HFpEF prevalence increased with shorter LTL (15.7%,11.2% and 7.9% across LTL tertiles, p = 0.037). Multivariable logistic regression analysis identified shorter LTL as an independent predictor of HFpEF (adjusted OR 2.087, 95% CI: 1.017, 4.280, p = 0.045), in addition to CHD, uric acid, and C-reactive protein. Compared with the long LTL group, both the short (adjusted hazard ratio [HR] 1.953, 95% CI 1.259-3.028; P = 0.003) and mid LTL groups (adjusted HR 1.581, 95% CI: 1.015-2.464, P = 0.043) showed a significantly increased risk of 5-year MACE. In conclusion, shorter LTL independently predicts HFpEF development and adverse cardiovascular outcomes in high-risk Chinese patients with hypertension under 65 years, suggesting telomere biology may contribute to HFpEF pathogenesis and clinical outcomes in this population.
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