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Research Article: HFpEF risk assessment using H 2 FPEF score in community-dwelling young Hispanic adults

Date Published: 2026-05-29

Abstract:
Heart failure with preserved ejection fraction (HFpEF) prevalence has increased with the increase in cardiometabolic risk factors and yet, diagnosis remains underrecognized in the community, with concomitant undertreatment. H 2 FPEF scoring is a validated tool for dyspnea evaluation but has potential to identify individuals with increased HFpEF risk in asymptomatic populations. Hispanics are known to have high prevalence of cardiometabolic risk, which predispose them to HFpEF. This study aimed to apply the H 2 FPEF score to a community-dwelling Hispanic cohort, and define demographic and clinical covariate associations, particularly in asymptomatic young Hispanic adults. Demographic, cardiometabolic and echocardiographic data were obtained in 1,285 asymptomatic participants (66% females, mean age 53?±?15 years) from the Cameron County Hispanic Cohort. H 2 FPEF scoring was performed, and the sample divided into low risk (0–2 points) or intermediate-high risk (3–7 points). Analysis was dichotomized to those <60 years and ?60 years of age, and multivariate logistic regression analyses were conducted. Intermediate-high risk H 2 FPEF score was seen in 43% ( n =?555) of the sample. Among those <60 years of age, a third (33%) already had intermediate-high H 2 FPEF scores. After adjusting for covariates, among young Hispanics, age [OR=1.02 (1.01–1.04)], metabolic syndrome [OR=2.16 (1.54–3.04)], higher hemoglobin A1c [OR 1.23 (1.08–1.39)] and sedentary lifestyle [OR=0.60 (0.41–0.88)] remained significantly associated with odds of increased H 2 FPEF score. We showed that a large proportion of Hispanics in our cohort have intermediate-high H 2 FPEF scores, and this pattern was already seen among young Hispanics. A simple and useful tool such as the H 2 FPEF score to identify persons at risk for HFpEF, particularly in communities with limited resources, may be relevant for prevention and early intervention, specifically targeting cardiometabolic risk control in young Hispanics.

Introduction:
Heart failure with preserved ejection fraction (HFpEF) is increasingly recognized as a leading cause of heart failure-related hospitalization and death in the United States ( 1 ). The variability in reported prevalence of HFpEF relate partly to different definitions of HFpEF used, different age cut-offs in studies, as well as geographical and true ethnic variations ( 2 , 3 ). Nevertheless, morbidity and mortality from HFpEF is projected to surpass that of heart failure with reduced ejection fraction, with an…

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