Congestive heart failure epidemiology and demographics: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 3: Line 3:
{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}}; Saleh El Dassouki, M.D [mailto:seldassouki@hotmail.com], Atif Mohammad, M.D.
{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}}; Saleh El Dassouki, M.D [mailto:seldassouki@hotmail.com], Atif Mohammad, M.D.


==Epidemiology of Heart Failure==
==Overview==


===Prevalance===
 
 
==Prevalance==


*Estimated 2005 prevalence in adults age 20 and older: 5,300,000 (about 2,650,000 males, and 2,650,000 females).
*Estimated 2005 prevalence in adults age 20 and older: 5,300,000 (about 2,650,000 males, and 2,650,000 females).


===Incidence <ref>[http://www.americanheart.org/downloadable/heart/1200082005246HS_Stats%202008.final.pdfHeart Disease and Stroke Statistics - 2008 Update, American Heart Association. Accessed on 09 March 2008]</ref> ===
==Incidence <ref>[http://www.americanheart.org/downloadable/heart/1200082005246HS_Stats%202008.final.pdfHeart Disease and Stroke Statistics - 2008 Update, American Heart Association. Accessed on 09 March 2008]</ref> ==


*Data from the NHLBI’s '''Framingham Heart Study''' indicate that;<ref>Lloyd-Jones DM, Larson MG, Leip EP, Beiser A, D'Agostino RB, Kannel WB, Murabito JM, Vasan RS, Benjamin EJ, Levy D; Lifetime Risk for Developing Congestive Heart Failure. Framingham Heart Study. Circulation. 2002; 106: 3068–72 PMID 12473553</ref>
*Data from the NHLBI’s '''Framingham Heart Study''' indicate that;<ref>Lloyd-Jones DM, Larson MG, Leip EP, Beiser A, D'Agostino RB, Kannel WB, Murabito JM, Vasan RS, Benjamin EJ, Levy D; Lifetime Risk for Developing Congestive Heart Failure. Framingham Heart Study. Circulation. 2002; 106: 3068–72 PMID 12473553</ref>
Line 19: Line 21:
*A study conducted in Olmsted County, Minnesota, showed that the incidence of heart failure (ICD9/428) has not declined during two decades, but survival after onset has increased overall, with less improvement among women and elderly persons. <ref>Véronique L. Roger, Susan A. Weston, Margaret M. Redfield, Jens P. Hellermann-Homan, Jill Killian, Barbara P. Yawn, Steven J. Jacobsen Trends in Heart Failure Incidence and Survival in a Community-Based Population JAMA. 2004; 292: 344-50 PMID 15265849</ref><ref name="pmid17905375">Thomas S, Rich MW (2007) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17905375 Epidemiology, pathophysiology, and prognosis of heart failure in the elderly.] ''Heart Fail Clin'' 3 (4):381-7. [http://dx.doi.org/10.1016/j.hfc.2007.07.004 DOI:10.1016/j.hfc.2007.07.004] PMID: [http://pubmed.gov/17905375 17905375]</ref>
*A study conducted in Olmsted County, Minnesota, showed that the incidence of heart failure (ICD9/428) has not declined during two decades, but survival after onset has increased overall, with less improvement among women and elderly persons. <ref>Véronique L. Roger, Susan A. Weston, Margaret M. Redfield, Jens P. Hellermann-Homan, Jill Killian, Barbara P. Yawn, Steven J. Jacobsen Trends in Heart Failure Incidence and Survival in a Community-Based Population JAMA. 2004; 292: 344-50 PMID 15265849</ref><ref name="pmid17905375">Thomas S, Rich MW (2007) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17905375 Epidemiology, pathophysiology, and prognosis of heart failure in the elderly.] ''Heart Fail Clin'' 3 (4):381-7. [http://dx.doi.org/10.1016/j.hfc.2007.07.004 DOI:10.1016/j.hfc.2007.07.004] PMID: [http://pubmed.gov/17905375 17905375]</ref>


Mostly as a result of the costs of hospitalization, it is associated with a high health expenditure; costs have been estimated to amount to 2% of the total budget of the [[National Health Service]] in the United Kingdom, and more than $35 billion in the United States.<ref name="pmid12034163">{{cite journal |author=Stewart S, Jenkins A, Buchan S, McGuire A, Capewell S, McMurray JJ |title=The current cost of heart failure to the National Health Service in the UK |journal=Eur. J. Heart Fail. |volume=4 |issue=3 |pages=361–71 |year=2002 |month=June |pmid=12034163 |doi= 10.1016/S1388-9842(01)00198-2|url=http://linkinghub.elsevier.com/retrieve/pii/S1388984201001982}}</ref><ref name="pmid18086926">{{cite journal |author=Rosamond W, Flegal K, Furie K, ''et al.'' |title=Heart disease and stroke statistics--2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee |journal=Circulation |volume=117 |issue=4 |pages=e25–146 |year=2008 |month=January |pmid=18086926 |doi=10.1161/CIRCULATIONAHA.107.187998 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=18086926}}</ref>
==Costs==
Heart failure is associated with significantly reduced physical and mental health, resulting in a markedly decreased [[quality of life]].<ref name="pmid11847161">{{cite journal |author=Juenger J, Schellberg D, Kraemer S, ''et al.'' |title=Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables |journal=Heart |volume=87 |issue=3 |pages=235–41 |year=2002 |month=March |pmid=11847161 |pmc=1767036 |doi= 10.1136/heart.87.3.235|url=http://heart.bmj.com/cgi/pmidlookup?view=long&pmid=11847161}}</ref><ref name="pmid12445536">{{cite journal |author=Hobbs FD, Kenkre JE, Roalfe AK, Davis RC, Hare R, Davies MK |title=Impact of heart failure and left ventricular systolic dysfunction on quality of life: a cross-sectional study comparing common chronic cardiac and medical disorders and a representative adult population |journal=Eur. Heart J. |volume=23 |issue=23 |pages=1867–76 |year=2002 |month=December |pmid=12445536 |doi= 10.1053/euhj.2002.3255|url=http://eurheartj.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=12445536}}</ref> With the exception of heart failure caused by reversible conditions, the condition usually worsens with time. Although some people survive many years, progressive disease is associated with an overall annual mortality rate of 10%.<ref name="neubauer-2007">{{cite journal | author=Neubauer S| title=The failing heart — an engine out of fuel | journal=N Engl J Med | year=2007 | volume=356 | issue=11 | pages=1140–51| pmid=17360992 | doi=10.1056/NEJMra063052}}</ref>
Mostly as a result of the costs of hospitalization, heart failure is associated with high costs which have been estimated to amount to 2% of the total budget of the [[National Health Service]] in the United Kingdom, and more than $35 billion in the United States.<ref name="pmid12034163">{{cite journal |author=Stewart S, Jenkins A, Buchan S, McGuire A, Capewell S, McMurray JJ |title=The current cost of heart failure to the National Health Service in the UK |journal=Eur. J. Heart Fail. |volume=4 |issue=3 |pages=361–71 |year=2002 |month=June |pmid=12034163 |doi= 10.1016/S1388-9842(01)00198-2|url=http://linkinghub.elsevier.com/retrieve/pii/S1388984201001982}}</ref><ref name="pmid18086926">{{cite journal |author=Rosamond W, Flegal K, Furie K, ''et al.'' |title=Heart disease and stroke statistics--2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee |journal=Circulation |volume=117 |issue=4 |pages=e25–146 |year=2008 |month=January |pmid=18086926 |doi=10.1161/CIRCULATIONAHA.107.187998 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=18086926}}</ref>
 
 


Heart failure is the leading cause of hospitalization in people older than 65.<ref>{{cite journal |author=Krumholz HM, Chen YT, Wang Y, Vaccarino V, Radford MJ, Horwitz RI |title=Predictors of readmission among elderly survivors of admission with heart failure |journal=Am. Heart J. |volume=139 |issue=1 Pt 1 |pages=72–7 |year=2000 |pmid=10618565|doi=10.1016/S0002-8703(00)90311-9}}</ref> In developed countries, the mean age of patients with heart failure is 75 years old. In developing countries, two to three percent of the population suffers from heart failure, but in those 70 to 80 years old, it occurs in 20—30 percent.
Heart failure is the leading cause of hospitalization in people older than 65.<ref>{{cite journal |author=Krumholz HM, Chen YT, Wang Y, Vaccarino V, Radford MJ, Horwitz RI |title=Predictors of readmission among elderly survivors of admission with heart failure |journal=Am. Heart J. |volume=139 |issue=1 Pt 1 |pages=72–7 |year=2000 |pmid=10618565|doi=10.1016/S0002-8703(00)90311-9}}</ref> In developed countries, the mean age of patients with heart failure is 75 years old. In developing countries, two to three percent of the population suffers from heart failure, but in those 70 to 80 years old, it occurs in 20—30 percent.

Revision as of 01:54, 3 April 2012

Congestive Heart Failure Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Systolic Dysfunction
Diastolic Dysfunction
HFpEF
HFrEF

Causes

Differentiating Congestive heart failure from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Clinical Assessment

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

Cardiac MRI

Echocardiography

Exercise Stress Test

Myocardial Viability Studies

Cardiac Catheterization

Other Imaging Studies

Other Diagnostic Studies

Treatment

Invasive Hemodynamic Monitoring

Medical Therapy:

Summary
Acute Pharmacotherapy
Chronic Pharmacotherapy in HFpEF
Chronic Pharmacotherapy in HFrEF
Diuretics
ACE Inhibitors
Angiotensin receptor blockers
Aldosterone Antagonists
Beta Blockers
Ca Channel Blockers
Nitrates
Hydralazine
Positive Inotropics
Anticoagulants
Angiotensin Receptor-Neprilysin Inhibitor
Antiarrhythmic Drugs
Nutritional Supplements
Hormonal Therapies
Drugs to Avoid
Drug Interactions
Treatment of underlying causes
Associated conditions

Exercise Training

Surgical Therapy:

Biventricular Pacing or Cardiac Resynchronization Therapy (CRT)
Implantation of Intracardiac Defibrillator
Ultrafiltration
Cardiac Surgery
Left Ventricular Assist Devices (LVADs)
Cardiac Transplantation

ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
Hospitalized Patient
Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
Patients with current or prior symptoms of heart failure (Stage C)
Patients with refractory end-stage heart failure (Stage D)
Coordinating Care for Patients With Chronic HF
Quality Metrics/Performance Measures

Implementation of Practice Guidelines

Congestive heart failure end-of-life considerations

Specific Groups:

Special Populations
Patients who have concomitant disorders
Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

Congestive heart failure epidemiology and demographics On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Congestive heart failure epidemiology and demographics

CDC on Congestive heart failure epidemiology and demographics

Congestive heart failure epidemiology and demographics in the news

Blogs on Congestive heart failure epidemiology and demographics

Directions to Hospitals Treating Congestive heart failure epidemiology and demographics

Risk calculators and risk factors for Congestive heart failure epidemiology and demographics

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Saleh El Dassouki, M.D [3], Atif Mohammad, M.D.

Overview

Prevalance

  • Estimated 2005 prevalence in adults age 20 and older: 5,300,000 (about 2,650,000 males, and 2,650,000 females).

Incidence [1]

  • Data from the NHLBI’s Framingham Heart Study indicate that;[2]
  1. Heart failure (HF) incidence approaches 10 per 1,000 population after age 65.
  2. 75% of heart failure cases have antecedent hypertension. About 22% of male and 46% of female myocardial infarction (MI) victims will be disabled with heart failure within following 6 years.
    • At age 40, the lifetime risk of developing heart failure for both men and women is 1 in 5.
    • At age 40, the lifetime risk of heart failure occurring without antecedent myocardial infarction is 1 in 9 for men and 1 in 6 for women.
    • The lifetime risk doubles for people with blood pressure >160/90 mm Hg compared to those with blood pressure <140/90 mm Hg.
  • A study conducted in Olmsted County, Minnesota, showed that the incidence of heart failure (ICD9/428) has not declined during two decades, but survival after onset has increased overall, with less improvement among women and elderly persons. [3][4]

Costs

Mostly as a result of the costs of hospitalization, heart failure is associated with high costs which have been estimated to amount to 2% of the total budget of the National Health Service in the United Kingdom, and more than $35 billion in the United States.[5][6]


Heart failure is the leading cause of hospitalization in people older than 65.[7] In developed countries, the mean age of patients with heart failure is 75 years old. In developing countries, two to three percent of the population suffers from heart failure, but in those 70 to 80 years old, it occurs in 20—30 percent.

Heart failure affects close to 5 million people in the USA and each year close to 500,000 new cases are diagnosed. What is of more concern is that more than 50% of patients seek re-admission within 6 months after treatment and the average duration of hospital stay is 6 days.

In tropical countries, the most common cause of HF is valvular heart disease or some type of cardiomyopathy. Moreover as underdeveloped countries become more affluent, there has also been an increase in diabetes, hypertension and obesity which has resulted in heart failure.

In USA, HF is much higher in African Americans, Hispanics, Native Americans and recent immigrants from the eastern bloc countries like Russia. This high prevalence in these ethnic populations has been linked to high incidence of diabetes and hypertension. In many new immigrants to the USA the high prevalence of heart failure has largely been attributed to lack of preventive health care or substandard treatment.[8]

Sex

Men have a higher incidence of heart failure, but the overall prevalence rate is similar in both sexes, since women survive longer after the onset of heart failure.[9] Women tend to be older when diagnosed with heart failure (after menopause), they are more likely than men to have diastolic dysfunction, and seem to experience a lower overall quality of life than men after diagnosis.[9]

Race

New information suggests that elements of heart failure in African Americans and Caucasians may be different[10] and therapy for heart failure has different efficacies depending on racial, ethnic, and genetic backgrounds.

References

  1. Disease and Stroke Statistics - 2008 Update, American Heart Association. Accessed on 09 March 2008
  2. Lloyd-Jones DM, Larson MG, Leip EP, Beiser A, D'Agostino RB, Kannel WB, Murabito JM, Vasan RS, Benjamin EJ, Levy D; Lifetime Risk for Developing Congestive Heart Failure. Framingham Heart Study. Circulation. 2002; 106: 3068–72 PMID 12473553
  3. Véronique L. Roger, Susan A. Weston, Margaret M. Redfield, Jens P. Hellermann-Homan, Jill Killian, Barbara P. Yawn, Steven J. Jacobsen Trends in Heart Failure Incidence and Survival in a Community-Based Population JAMA. 2004; 292: 344-50 PMID 15265849
  4. Thomas S, Rich MW (2007) Epidemiology, pathophysiology, and prognosis of heart failure in the elderly. Heart Fail Clin 3 (4):381-7. DOI:10.1016/j.hfc.2007.07.004 PMID: 17905375
  5. Stewart S, Jenkins A, Buchan S, McGuire A, Capewell S, McMurray JJ (2002). "The current cost of heart failure to the National Health Service in the UK". Eur. J. Heart Fail. 4 (3): 361–71. doi:10.1016/S1388-9842(01)00198-2. PMID 12034163. Unknown parameter |month= ignored (help)
  6. Rosamond W, Flegal K, Furie K; et al. (2008). "Heart disease and stroke statistics--2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee". Circulation. 117 (4): e25–146. doi:10.1161/CIRCULATIONAHA.107.187998. PMID 18086926. Unknown parameter |month= ignored (help)
  7. Krumholz HM, Chen YT, Wang Y, Vaccarino V, Radford MJ, Horwitz RI (2000). "Predictors of readmission among elderly survivors of admission with heart failure". Am. Heart J. 139 (1 Pt 1): 72–7. doi:10.1016/S0002-8703(00)90311-9. PMID 10618565.
  8. Heart Failure Information, Retrieved on 2010-01-21.
  9. 9.0 9.1 Strömberg A, Mårtensson J. (2003). "Gender differences in patients with heart failure". Eur. J. Cardiovasc. Nurs. 2 (1): 7–18. doi:10.1016/S1474-5151(03)00002-1. PMID 14622644. Unknown parameter |month= ignored (help)
  10. Aronow, WS (1999). "Comparison of incidence of congestive heart failure in older African-Americans, Hispanics, and Caucasians". Am J of Cardiol. 84 (5): 611–2. doi:10.1016/S0002-9149(99)00392-6. PMID 10482169. Unknown parameter |coauthors= ignored (help)


Template:WikiDoc Sources