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UK Biobank data show that poor mental health, deprivation and air pollution significantly raise the risk of heart failure in women, with up to a quarter of cases potentially preventable
New analysis of health data from more than 230,000 women in the UK Biobank study suggests that depression, socioeconomic hardship, and exposure to polluted environments are tied to a significantly elevated risk of heart failure in women. Researchers say these under‑recognised factors may contribute nearly as much to risk as traditional causes such as high blood pressure and diabetes, with risk levels comparable to those of traditional causes. They also estimate that up to one in four cases could be preventable if these broader influences were addressed.
Overlooked factors play a major role in heart failure in women
Heart failure occurs when the heart becomes too weak or stiff to pump blood effectively throughout the body. High blood pressure, high cholesterol levels or smoking are more likely to develop heart failure, all of which are frequently targeted in public health campaigns.
Peige Song from China’s Zhejiang University and her team found that living in polluted areas, having poor mental wellbeing, facing socioeconomic deprivation, and experiencing chronic inflammatory conditions such as lupus make women more prone to heart failure. These risks, however, are often overlooked.
“[The study] is a call to redefine prevention in women’s cardiovascular health, integrating biological, psychosocial and structural determinants into a unified, equitable approach,” Song says.
Study reveals scale of preventable heart failure in women
The researchers analysed data from over 230,000 female UK Biobank participants and found that mental wellbeing, environmental exposures, socioeconomic circumstances, and reproductive history together contributed almost as much risk for heart failure as all well-known risks combined. In particular, the study highlights that risk rises with socioeconomic hardship and chronic inflammatory conditions, such as lupus or rheumatoid arthritis, approaching the impact of conventional risk factors.
“One in four heart-failure cases in women could be prevented if all under-recognised risk factors were eliminated, assuming causal relationships,” Song says. While completely eliminating all risks isn’t realistic, she adds, “even partial reductions – through better mental health services, social equity policies and environmental regulations – could yield significant public health benefits”.
“These calculations show convincingly that under-recognised and female-specific risk factors contribute significantly to heart failure in women, independently of the well-established ones,” says women’s health specialist Catherine Pirkle of the University of Hawaiʻi at Mānoa in the US.
“It’s important to understand that heart health is influenced by more than just blood pressure or cholesterol,” Song concludes. “Factors like mental wellbeing, reproductive milestones and socioeconomic conditions all matter. Awareness and advocacy for comprehensive, gender-sensitive care are key.”