ORIGINAL CONTRIBUTION Insulin Resistance and Risk of Congestive Heart Failure

CONGESTIVE HEART FAILURE(CHF) is a major cause ofmorbidity and mortality. Theage-adjusted mortality for pa-tients with CHF is 4 to 8 times that of the general population.1 The predomi-nant causes of heart failure are hyper-tension and coronary heart disease. Other established risk factors for CHF include left ventricular hypertrophy (LVH), valvular heart disease, diabe-tes, cigarette smoking, obesity, and dys-lipidemia.1-4 Diabetes as a predictor of subsequent CHF was first described in the Framing-ham Heart Study 3 decades ago,5 and the disease is frequently cited as a risk fac-tor for CHF.1,2,6,7 Yet, more detailed char