Abstract 3897: Long Term Trends in Heart Failure: Is There Really an Epidemic?
Background: Previous studies have documented a rapid increase in Heart failure (HF) incidence and prevalence over the last 2 decades. However, HF-related mortality has decreased during this time-period. Recent trends of HF in Canada have not been examined.
Methods: We used administrative population health data available through the Alberta Cardiovascular Access Collaborative. All patients hospitalized or with an emergency department (ED) admission with HF (ICD9 428.x, ICD10 I50) between 2000 and 2006 in Alberta, Canada were included in the analyses. Unadjusted age and sex standardized rates (ASR) are presented per 1000 population (/1000 pop).
Results: HF prevalence rose substantially from 24.9/1000 pop in 2000 to 32.1/1000 pop in 2006 (Figure⇓). Over this 6-year period, 73,650 patients had a first hospitalization or ED visit for HF. Age-adjusted HF incidence rates (/1000 pop) were 6.07, 5.97, 5.37, 5.23, 4.98 and 5.09 for the years 2000 to 2006, respectively for men, and 5.98, 5.34, 5.23, 4.95 and 4.98 for women (both p<0.001). One-year mortality among incident cases decreased from 18.7% in 2000/01 to 17.5% in 2004/05: this corresponded to a relative improvement of 6.4% (7.8% for men and 5.5% for women). However, the number of ED visits and hospitalizations per incident HF patient remained constant at 1.3 hospitalizations per patient per year over the 6 years.
Discussion: Despite previous reports of the emergence of a HF epidemic, HF incidence appears to have declined. However, prevalence has increased coupled with a relative 6.4% decline of all-cause mortality over a relatively short period of time. Improvements in management may have lead to this decline.