A well-known investigation into the causes and risk factors of cardiovascular disease began in 1948. Known as the Framingham Study, the research studied 5209 men and women and eventually began to study over 5000 of the original group's offspring.

One of the first findings of the study, and many that followed, was that hypertension or high blood pressure is a leading risk factor for heart disease. Not surprisingly, high blood pressure and the lifestyle factors that cause it are among the leading factors that increase the risk of congestive heart failure (CHF).

A history of heart disease that includes atherosclerosis and heart attacks also indicates an increased risk of CHF. Clearly, progressive damage to the heart will reduce its function and prevent it from working properly.

Age and Gender

The incidence of CHF rises significantly with age. While more people are diagnosed with CHF, they tend to live longer with heart failure than they did in the past. Men are at higher risk for developing CHF than women, however women are more likely to die of heart failure after a heart attack.

Ethnicity and Genetics

African Americans are more likely than Caucasians to suffer from CHF. Furthermore, African American women are at greater risk than African American men. While this population is at highest risk for high blood pressure and diabetes, researchers conclude that those two factors do not fully account for the higher mortality rate from CHF in African American women.

A family history of CHF increases the risk, particularly if the CHF occurs at an early age and is caused by cardiomyopathy.

What is Cardiomyopathy?

The word cardiomyopathy is derived from Latin and Greek words that mean "a disease of the heart muscle." Medically, cardiomyopathy is a condition in which the heart muscle becomes damaged and ceases to work properly.

Alcohol Abuse

Chronic alcohol abuse can cause heart damage and cardiomyopathy, thereby increasing the risk of congestive heart failure. Furthermore, people who consistently abuse alcohol tend to suffer from high blood pressure, which also increases the risk of CHF.

Medical Causes

A number of medical conditions increase the risk of developing CHF. These include the following:

• Atherosclerosis is the buildup of cholesterol deposits in the arteries. It can lead to CHF by hindering blood flow. Angina and previous heart attacks also increase CHF risk.
• Hypertension or high blood pressure causes CHF by forcing the heart to work harder to pump blood. The heart initially gets bigger, but eventually weakens.
• Valvular Disease causes the heart's valves — little trap doors that open and close with each heartbeat — to develop defects or leaks that impair proper blood flow.
• Cardiomyopathy in its different forms can lead to CHF. The three main types are dilated congestive, hypertrophic andrestrictive cardiomyopathy.
• Lung Disease, particularly pulmonary hypertension and chronic obstructive pulmonary disease (emphysema and bronchitis), force the heart to work harder as it tries to pump oxygen-poor blood through the lungs to replenish the oxygen.
• Diabetes increases the risk of developing CHF by two to eight times. Women are at greater risk than men. While diabetes elevates the risk of heart disease in general, diabetes itself causes damage to the heart muscle.
• Early childhood cancers, particularly those treated with specific types of chemotherapy, increase the risk of heart failure later in life.
• Congenital heart disease includes structural heart defects that exist at birth.
• Peripartum cardiomyopathy is a rare condition that causes heart failure when a woman is giving birth.
• Hyperthyroidism places strain on the heart and increase the risk of heart failure.
• Amyloidosis is a buildup of amyloids or starchy proteins in the tissues and organs. It greatly increases the risk of heart failure.
• Thiamine deficiency is a lack of vitamin B1. It can cause reversible cardiomyopathy.
• Acute myocarditis is an infection of the heart caused by a virus. The problem is usually temporary.
• Anabolic steroids used for long periods to build muscles can increase CHF risk.

Generally, any disease that increases the risk of heart disease is also likely to increase the risk of congestive heart failure. The existence of a combination of two or more of these factors greatly increases the risk of CHF.

Who Gets Congestive Heart Failure?

Congestive heart failure is a disease characteristic of our aging population.

• Two percent of persons aged 40 to 59 have congestive heart failure.
• Congestive heart failure affects more than five percent of people aged 60 to 69. age bracket.
• Approximately ten percent of people over age 70 have congestive heart failure.