Poor heart and metabolic health with frailty linked to heart failure
People with poor heart and metabolic health and pre-frailty or frailty had a heart failure hazard ratio of 2.76 versus healthy, non-frail participants.
An observational cohort study followed 319,048 UK Biobank participants who initially had neither atrial fibrillation, an irregular heartbeat, nor heart failure, in which the heart does not pump blood well enough. Researchers formed four groups based on cardiometabolic health, which covers heart health and the body's use of energy, and frailty, reduced resilience to illness and stress.
Those with poor cardiometabolic health and pre-frailty or frailty had the highest risks of both conditions. Compared with healthy, non-frail participants, their hazard ratios, which compare the rates at which conditions developed, were 2.76 for heart failure and 1.49 for atrial fibrillation. They also had higher risks of progressing from either condition to having both. Exploratory blood-protein analyses in 28,206 participants identified the blood protein FABP4 as the most consistent preliminary signal related to these links.
Why it matters
Tracking atrial fibrillation and heart failure together addressed a question relevant to healthy aging: how people progress from one heart condition to having both.
Caveats
This observational study cannot show that frailty or poor cardiometabolic health caused the conditions. The protein findings were exploratory and need validation in independent cohorts.
- FABP4
- Lipid and ceramide metabolism
- Heart failure
- Atrial fibrillation
- Atrial fibrillation and heart failure comorbidity
- Humans
The paper
The First Affiliated Hospital of Bengbu Medical University
The Journal of Nutrition, Health & Aging, 10 Oct 2026
