Increasing risk for heart failure in aging US population
(30 June 2005: VIDYYA MEDICAL NEWS SERVICE) -- Although heart failure is often referred to as one of the new “epidemics” of cardiovascular disease in the 21st century, there have been few community-based studies that gauge the risks of heart failure in a general population. In a report published in the July issue of The American Journal of Medicine, researchers from the University of Massachusetts Medical School looked at the incidence of heart failure in residents of the Worcester, Massachusetts metropolitan area. The results of this study suggest that heart failure is an important clinical syndrome affecting residents of this large northeast community. Several groups at high risk for developing or dying from heart failure can be identified and targeted for preventive efforts as well as for the receipt of effective treatment modalities.
Information was collected for 2548 adult men and women of all ages hospitalized for possible heart failure (HF) at all 11 greater Worcester medical centers during 2000. Demographic, medical history, laboratory and physiologic measures, and clinical characteristics of the study sample were determined through the review of information contained in hospital medical records. The incidence rate (per 100,000) of HF was 213. Occurrence of acute HF increased markedly with advancing age and women were at greater risk for HF than men (incidence rates [per 100 000] = 246 and 189, respectively).
In the total study sample, 5.1% of patients with decompensated HF died during the acute hospitalization. Among patients with a first documented episode of HF, 5.5% of patients died. Patients dying during the acute hospitalization were more likely to be older, of desirable body weight, and have a history of anemia or stroke. Patients with higher concentrations of blood urea nitrogen, serum creatinine, and admission heart rates were more likely to die than respective comparison groups. On the other hand, patients with lower serum sodium concentrations and lower systolic and diastolic blood pressure values were at greater risk for dying during hospitalization than patients with higher levels of these clinical variables.
Writing in the article, senior investigator Robert J. Goldberg, PhD, states, “Our findings … argue for the importance of population-based registries for the more systematic study of this clinical syndrome. These community-wide surveillance projects need to be developed and maintained for long periods of time to provide timely and ongoing insights to the effective primary and secondary prevention of this serious clinical problem.”
He continues, “The results of the present investigation confirm that acute HF represents a considerable burden to the health of the community, particularly in older individuals. Given the aging of the U.S. population, and declining national death rates due to cardiovascular disease placing these individuals at increased risk for HF during their latter years of life, increasing trends in the magnitude and morbidity of HF are likely to continue for the foreseeable future. These trends, as well as changes in the management of patients with acute and chronic manifestations of HF over time, warrant further monitoring, particularly in representative U.S. communities.”
The study is reported in “Incidence and hospital death rates associated with heart failure: a community-wide perspective” by Robert J. Goldberg, PhD, Cheryl Farmer, MD, Theo E. Meyer, MD, and Stephen Pezzella, MD. It appears in The American Journal of Medicine, Volume 118, Number 7 (July 2005), published by Elsevier.
The July 2005 issue of The American Journal of Medicine is the first in a series of specialty theme issues and focuses on cardiology. Featured articles include:
Update on the drug treatment of hypertension in patients with cardiovascular disease (White)
Low-dose aspirin increases aspirin resistance in patients with coronary artery disease (Lee et al)
Incidence and hospital death rates associated with heart failure: A community-wide perspective (Goldberg et al)
Aortic valve replacement in patients with mild or moderate aortic stenosis and coronary bypass surgery (Pereira et al)
Latin American randomized trial of balloon angioplasty vs coronary stenting for small vessels (LASMAL): Immediate and long-term results (Rodriguez)
Recurrent infarction causes the most deaths following myocardial infarction with left ventricular dysfunction (Ørn et al)
Enterococcal endocarditis: 107 cases from the international collaboration on endocarditis merged database (McDonald et al)
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