Metabolic disorders as growing risk factors and comorbidities in heart failure

We have read the article by Stefano Ciardullo and colleagues with great interest [1]. The authors analyzed data from the National Health and Nutrition Examination Surveys (NHANES) and found that the prevalence of heart failure (HF) remained stable for nearly two decades in US adults [1]. Simultaneously, there was an increased prevalence of obesity and diabetes in patients with HF [1]. We congratulate the authors on their important work. We raise three interpretation issues with the results.