Primary prevention strategies to mitigate the burden of heart failure (HF) are urgently
needed. However, no validated risk prediction tools are currently in use. We sought
to derive 10-year risk equations of developing incident HF. Race- and sex-specific
10-year risk equations for HF were derived and validated from individual-level data
from 7 community-based cohorts with at least 12 years of follow-up. Participants who
were recruited between 1985-2000, between 30 to 80 years, and were free of cardiovascular
disease at baseline were included to create a pooled cohort (PC) and randomly split
for derivation and internal validation. Model performance was also assessed in 2 additional
cohorts. In the derivation sample of the PC (n=11771), 58% were women, 22% were black
with a mean age 52±12 years, and HF occurred in 1339 participants. Predictors of HF
included in the race-sex specific models were age, blood pressure (treated or untreated),
fasting glucose (treated or untreated), body mass index, cholesterol, smoking status,
and QRS duration. The PC equations to Prevent HF (PCP-HF) model had good discrimination
and strong calibration in internal and external validation cohorts. A web-based tool
was developed to facilitate clinical application of this tool. We present a contemporary
analysis from 33,010 men and women demonstrating the utility of the sex and race-specific
10-year PCP-HF risk score, which integrates clinical parameters readily available
in primary care settings. This tool can be useful in risk-based decision making to
determine who may merit intensive screening and/or targeted prevention strategies.
There is an is urgent need to identify strategies to prevent heart failure given the
substantial morbidity, mortality, and cost associated with HF. We developed the Pooled
Cohort equations to Prevent HF (PCP-HF) to estimate 10-year risk of incident HF among
participants aged 30-80 years from 5 population-based cohorts. We assessed model performance
internally and validated it externally in 2 large cohorts. The PCP-HF risk score demonstrated
good discrimination and calibration. The PCP-HF risk score is a novel tool that integrates
clinical risk factor data and may be useful in individual level risk-based decision
making and population-level prevention of HF.