A nurse is reviewing a client's medical record. Which of the following findings places the client at increased risk for the development of heart failure? (Select all that apply.)

Rationale: A. Diabetes mellitus is a major risk factor for heart failure. Chronic hyperglycemia contributes to atherosclerosis, coronary artery disease, and diabetic cardiomyopathy, all of which can impair myocardial function and lead to heart failure. B. Hypotension is not a typical risk factor for developing heart failure. In fact, heart failure more commonly leads to hypotension in advanced stages due to decreased cardiac output. While severe hypotension can affect organ perfusion, it is not a primary contributor to chronic heart failure development. C. Chronic excessive alcohol intake can cause alcoholic cardiomyopathy, which weakens the heart muscle and reduces its ability to pump effectively, significantly increasing the risk of heart failure. D. Osteoarthritis is a degenerative joint condition and does not directly affect cardiac function or increase the risk of heart failure. It is not a cardiovascular risk factor. E. Obstructive sleep apnea contributes to intermittent hypoxia, increased sympathetic stimulation, and hypertension, all of which place strain on the heart and increase the risk of developing heart failure over time.