(Circulation. 2003;108:129.)
© 2003 American Heart Association, Inc.
Editorials |
From the Stanford University School of Medicine, Stanford, Calif.
Correspondence to Sharon A. Hunt, MD, Falk Cardiovascular Research Center, CVRC 265, Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5406. E-mail hunts@leland.stanford.edu
Key Words: Editorials heart failure population patients aging
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
Over the last 2 decades, improved understanding of the pathophysiology of heart failure has led to significant progress in the treatment of this syndrome. Nevertheless, heart failure remains a clinical problem of truly epidemic proportions, affecting nearly 5 million people in the United States.1,2 Moreover, the lifetime risk of developing heart failure may be as high as 20%, with an annual incidence of new cases of well over a half million per year.13 Beyond this human crisis, heart failure also presents a tremendous economic challenge as a result of the enormous costs of caring for this patient population.4 Unfortunately, this clinical and economic burden predictably will continue to increase as further therapeutic advances are made in the treatment of ischemic heart disease, creating an older surviving population at risk for developing heart failure. Although there has been some improvement in heart failure survival over the years, overall mortality remains high at >30% despite the introduction of ACE inhibitor and ß-blocker therapies,2,5 which have been proven in landmark trials to markedly improve survival.6,7 This lack of striking improvement in survival rates outside of clinical trials may be a result of the well-documented obstacles faced in effecting appropriate changes in physician behavior,8 which in turn lead to significant under-use of proven medications and therapies.9 It is also possible that the ever-increasing complexity and multitude of recommended treatments is simply daunting and difficult to understand, causing these therapies not to be used, especially by practitioners who lack the time or the expertise to
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