A large-scale analysis of over 6,000 smart bed users suggests a significant hidden burden of heart failure with preserved ejection fraction (HFpEF), a serious condition that is difficult to diagnose PMID:41032000. The study found that nearly 10% of individuals exhibited symptoms and risk profiles indicative of undiagnosed HFpEF, which was strongly associated with a cluster of sleep abnormalities. These findings highlight the potential of using passive monitoring and symptom awareness for early detection of a disease that often goes unnoticed until it becomes severe. ### Key Findings The cross-sectional study utilized a validated algorithm based on age, BMI, and atrial fibrillation history (HFpEF-ABA) to estimate the probability of HFpEF. - **Estimated Prevalence:** Based on the algorithm, the prevalence of potentially undiagnosed HFpEF in the cohort was **10.0%**. - **Key Symptom:** Chronic exertional dyspnea (shortness of breath with activity) was reported by **17.7%** of participants and was strongly linked to a higher probability of having HFpEF. - **Sleep Disturbances:** A higher probability of HFpEF was significantly associated with multiple sleep issues, including shorter sleep duration, more frequent napping, restless sleep, and nocturia (waking frequently to urinate). - **Physiological Markers:** Higher HFpEF probability also correlated with measurable changes during sleep, such as increased respiratory rate and altered heart rate variability, indicating physiological stress. ### The Longevity Context HFpEF is a critical concern for longevity, as it carries a severe prognosis. It is not a benign condition of aging; the mortality rate can be as high as 29% within one year and 65% within five years of diagnosis PMID:39503170. Early detection is crucial because the condition is driven by underlying systemic issues. Research suggests a systemic pro-inflammatory state, often linked to comorbidities like obesity and diabetes, is a primary driver of the myocardial stiffness characteristic of HFpEF PMID:31064116. This connects the disease directly to core pillars of metabolic health that are central to longevity strategies. The challenge with HFpEF is that its defining symptoms, particularly shortness of breath during activity, may not be apparent during a standard resting check-up PMID:23711448. This is why the condition is frequently missed. The primary study's use of a simple, non-invasive screening algorithm based on readily available clinical data—age, BMI, and atrial fibrillation history—represents a powerful tool for flagging at-risk individuals who may benefit from further diagnostic testing PMID:41032000. ### Actionable Protocol This research highlights the importance of proactive self-monitoring for early signs of HFpEF. This protocol is for risk awareness and is not a diagnostic tool. Consult a physician for a formal evaluation. 1. **Monitor for Key Symptoms:** Pay close attention to new or worsening **exertional dyspnea**. This means feeling out of breath during activities that were previously easy, like climbing stairs or carrying groceries. Also note persistent fatigue or swelling in the ankles or legs. 2. **Correlate with Sleep Quality:** Consider the above symptoms in the context of your sleep. Are you experiencing chronically short or restless sleep, a new need for daytime naps, or frequently waking to urinate (nocturia)? The combination of these symptoms is a stronger signal. 3. **Assess Your Risk Profile:** The HFpEF-ABA score is based on three factors: **Age** (risk increases significantly with age), **Body Mass Index (BMI)** (obesity is a major risk factor), and a known history of **Atrial Fibrillation**. 4. **Seek Medical Consultation:** If you have a combination of the symptoms and risk factors listed above, discuss the possibility of HFpEF with your doctor. A formal diagnosis often requires an echocardiogram and sometimes an exercise stress test to assess heart function under load.