Abstract 15936: Age-specific Trends in Incidence and Prognosis of Heart Failure in Denmark
Introduction: The cumulative burden and impact of risk factors on cardiovascular disease (CVD) outcomes have changed over the last few of decades. Prior reports have suggested that the incidence of heart failure has declined among older individuals. Obesity rates and sedentary behaviour have increased among the younger segment, but the impact of these trends on heart failure incidence is unknown.
Hypothesis: Trends in CVD risk factors have influenced the incidence and mortality of heart failure differentially among younger versus older individuals.
Methods: We evaluated the age-specific trends in incidence and 1-year mortality rates of heart failure (based on first-time in-hospital diagnoses) in Denmark between 1995 and 2012 among people aged >18 years. Data was collected from 3 nationwide Danish registries. Annual incidence rates of heart failure and 1-year standardized mortality rates were calculated assuming a Poisson distribution.
Results: We identified 209,488 individuals with a first-time diagnosis of heart failure. Annual incidence rates per 10,000 person-years declined among older individuals between 1995 and 2012 (163 vs. 115 in >74 years, 63 vs. 35 in 65-74 years, 23 vs. 20 in 55-64 years, p<0.0001 for all), but increased among younger individuals (0.5 vs. 0.8 in 18-34 years, 1.5 vs. 2.7 in 35-44 years, and 5.8 vs. 7.1 in 45-54 years, p<0.0001 for all). Sex- and age-adjusted incidence rate ratios (95% confidence intervals) for 2012 vs. 1996 were 0.69 (0.67-0.71) among people ≥50 years, and 1.52 (1.33-1.73) among individuals <50 years. Additional adjustment for diabetes, ischemic heart disease, and hypertension slightly magnified both the observed decline among people ≥50 years (0.62 [0.60-0.64]) and the observed increase among individuals <50 years (1.63 [1.43-1.63]). Standardized 1-year mortality rates in heart failure patients declined for middle-aged patients (45-64 years) and remained fairly constant for younger and older.
Conclusions: Our observations using nationwide data suggest divergent trends in heart failure incidence and mortality in older versus younger individuals, with worrisome increasing trends in the young. These observations portend a rising burden of heart failure in the community in the future.
Author Disclosures: M.N. Christiansen: None. L. Køber: None. J. Jeppensen: None. C. Torp-Pedersen: None. G. Gislason: None. P. Weeke: None. V.S. Ramachandran: None. C. Andersson: None.
- © 2016 by American Heart Association, Inc.