Abstract 15685: Contemporary Appraisal of the Heart Failure Epidemic, 2000-2010
Background: Heart failure (HF) is commonly referred to as an epidemic posing major clinical and public health challenges. Yet, contemporary data on its magnitude and implications are scarce. We evaluated recent trends in incidence, mortality and hospitalizations in a geographically defined population.
Methods: Residents of Olmsted County, Minnesota, with validated incident HF from 2000-2010 were studied. Incidence rates were calculated, overall and by preserved (HFpEF) or reduced (HFrEF) ejection fraction (EF). Outcomes included death and hospitalizations.
Results: A total of 2,762 individuals had incident HF during the study period (mean age, 76 years; 43% male). The age- and sex-adjusted incidence rate of HF declined substantially [average annual percent change, -4.6; 95% confidence interval (CI): -3.5 to -5.7], equating to a 40% decline over the last decade (rate ratio 0.60; 95% CI: 0.52 to 0.69). The decline in incidence was observed for HFpEF and HFrEF and among all demographic groups, with some variation between categories (Figure). Mortality was high, frequently ascribed to non-cardiovascular causes (54%), and did not decline over time. It did not differ by sex or EF, but was markedly higher in the elderly (24% for 60 vs. 54% for 80 year-olds after 5 years). Hospitalizations were common (mean, 1.40 per person-year; 95% CI: 1.31-1.50), particularly among men, and the majority (62%) were due to non-cardiovascular causes. While hospitalization rates for cardiovascular causes did not change over time, the rates for non-cardiovascular causes increased (Ptrend=0.03).
Conclusions: Over the last decade, the incidence of HF declined substantially contrasting with no detectable change in mortality. Non-cardiovascular conditions play an increasing role in hospitalizations and remain the most frequent cause of death. This underscores the need to augment disease-centric management approaches with holistic strategies to reduce the population burden of HF.
Author Disclosures: Y. Gerber: None. S.A. Weston: None. M.M. Redfield: Honoraria; Modest; HFSA CME presentation. Consultant/Advisory Board; Modest; Eli Lily Co., Novartis- unpaid advisory. A.M. Chamberlain: None. S.M. Manemann: None. R. Jiang: None. J.M. Killian: None. V.L. Roger: None.
- © 2014 by American Heart Association, Inc.