Epidemiology of heart failure

Abstract

Abstract Heart failure (HF) affects an estimated 64 million people worldwide. Ischaemic heart disease, chronic obstructive pulmonary disease, hypertensive heart disease, and rheumatic heart disease are responsible for over two-thirds of HF cases worldwide. While HF incidence rates appear stable, its prevalence is still increasing. The global incidence ranges from 1 to 9 cases per 1000 person-years, and the prevalence is estimated to be 1–2% of the general adult population. Prevalence estimates of all types of HF range from 0.7% to 1.3% in those aged #lt;55 years, and from 4.7% to 13.3% in those aged ≥65 years. Suboptimal control of five modifiable risk factors (smoking, diabetes, hypertension, hyperlipidaemia, and obesity) accounts for an estimated 88.8% of incident cases of HF. Hospitalization due to HF represents 1–2% of all hospital admissions (with more than half of those patients aged #gt;75 years), with a median number of HF discharges per million people assessed of 2671. Around 20% of patients are readmitted after 30 days, with over half during the first year and over 80% within 5 years after initial hospitalization. One- and 5-year mortality rates are 10.7% and 40.3%, respectively. Determinants of prognosis are age, renal function, blood pressure, sodium level, ejection fraction, male sex, natriuretic peptide levels, New York Heart Association class, diabetes, body mass index, and exercise capacity. The distribution of different phenotypes of HF is changing, with an increasing proportion of patients with heart failure with preserved ejection fraction. Heart failure with reduced ejection fraction is the most well studied, and clear prognostic benefits of therapy have been demonstrated in clinical trials.

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