Heart failure (HF) is a major public health issue, with a prevalence of over 5.8 million in the USA, and over 23 million worldwide, and rising. The lifetime risk of developing HF is one in five. Although promising evidence shows that the age-adjusted incidence of HF may have plateaued, HF still carries substantial morbidity and mortality, with 5-year mortality that rival those of many cancers. HF represents a considerable burden to the health-care system, responsible for costs of more than $39 billion annually in the USA alone, and high rates of hospitalizations, readmissions, and outpatient visits. HF is not a single entity, but a clinical syndrome that may have different characteristics depending on age, sex, race or ethnicity, left ventricular ejection fraction (LVEF) status, and HF etiology. Furthermore, pathophysiological differences are observed among patients diagnosed with HF and reduced LVEF compared with HF and preserved LVEF, which are beginning to be better appreciated in epidemiological studies. A number of risk factors, such as ischemic heart disease, hypertension, smoking, obesity, and diabetes, among others, have been identified that both predict the incidence of HF as well as its severity. In this Review, we discuss key features of the epidemiology and risk profile of HF.
Heart failure (HF) is a major public health issue that affects nearly 5.8 million individuals in the USA and 23 million worldwide
The prevalence of HF is increasing owing to the aging population and improved management of heart disease, but the age-adjusted incidence of HF seems to have plateaued
HF and preserved left ventricular ejection fraction (LVEF) has an increasingly prominent role in HF, representing more than half of HF cases, with outcomes similar to HF and reduced LVEF
Although mortality from HF has improved over the past few decades, it still results in a high 5-year mortality that rivals that of many cancers
Risk factors, such as ischemic heart disease, hypertension, smoking, obesity, and diabetes increase the risk of incident HF and predict poor outcomes in the setting of the disease
HF is a major source of health services utilization, being a leading cause of hospitalizations, readmissions, and outpatient visits at a cost of over $39 billion annually in the USA
Subscribe to Journal
Get full journal access for 1 year
only $17.42 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
Lloyd-Jones, D. et al. Heart disease and stroke statistics—2010 update: a report from the American Heart Association. Circulation 121, e46–e215 (2010).
McMurray, J. J., Petrie, M. C., Murdoch, D. R. & Davie, A. P. Clinical epidemiology of heart failure: public and private health burden. Eur. Heart J. 19 (Suppl. P), P9–P16 (1998).
Levy, D. et al. Long-term trends in the incidence of and survival with heart failure. N. Engl. J. Med. 347, 1397–1402 (2002).
Schocken, D. D., Arrieta, M. I., Leaverton, P. E. & Ross, E. A. Prevalence and mortality rate of congestive heart failure in the United States. J. Am. Coll. Cardiol. 20, 301–306 (1992).
Fang, J., Mensah, G. A., Croft, J. B. & Keenan, N. L. Heart failure-related hospitalization in the U.S., 1979 to 2004. J. Am. Coll. Cardiol. 52, 428–434 (2008).
Hoes, A. W., Mosterd, A. & Grobbee, D. E. An epidemic of heart failure? Recent evidence from Europe. Eur. Heart J. 19 (Suppl. L), L2–L9 (1998).
McCullough, P. A. et al. Confirmation of a heart failure epidemic: findings from the Resource Utilization Among Congestive Heart Failure (REACH) study. J. Am. Coll. Cardiol. 39, 60–69 (2002).
Croft, J. B. et al. Heart failure survival among older adults in the United States: a poor prognosis for an emerging epidemic in the Medicare population. Arch. Intern. Med. 159, 505–510 (1999).
Rich, M. W. Heart failure in the 21st century: a cardiogeriatric syndrome. J. Gerontol. A Biol. Sci. Med. Sci. 56, M88–M96 (2001).
Barker, W. H., Mullooly, J. P. & Getchell, W. Changing incidence and survival for heart failure in a well-defined older population, 1970–1974 and 1990–1994. Circulation 113, 799–805 (2006).
Loehr, L. R., Rosamond, W. D., Chang, P. P., Folsom, A. R. & Chambless, L. E. Heart failure incidence and survival (from the Atherosclerosis Risk in Communities study). Am. J. Cardiol. 101, 1016–1022 (2008).
Roger, V. L. et al. Trends in heart failure incidence and survival in a community-based population. JAMA 292, 344–350 (2004).
Senni, M. et al. Congestive heart failure in the community: trends in incidence and survival in a 10-year period. Arch. Intern. Med. 159, 29–34 (1999).
[No authors listed] Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). The CONSENSUS Trial Study Group. N. Engl. J. Med. 316, 1429–1435 (1987).
Jhund, P. S. et al. Long-term trends in first hospitalization for heart failure and subsequent survival between 1986 and 2003: a population study of 5.1 million people. Circulation 119, 515–523 (2009).
Tu, J. V. et al. National trends in rates of death and hospital admissions related to acute myocardial infarction, heart failure and stroke, 1994–2004. CMAJ 180, E118–E125 (2009).
Redfield, M. M. Heart failure—an epidemic of uncertain proportions. N. Engl. J. Med. 347, 1442–1444 (2002).
Lee, D. S. et al. Trends in heart failure outcomes and pharmacotherapy: 1992 to 2000. Am. J. Med. 116, 581–589 (2004).
Bhatia, R. S. et al. Outcome of heart failure with preserved ejection fraction in a population-based study. N. Engl. J. Med. 355, 260–269 (2006).
Massie, B. M. et al. Irbesartan in patients with heart failure and preserved ejection fraction. N. Engl. J. Med. 359, 2456–2467 (2008).
Owan, T. E. et al. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N. Engl. J. Med. 355, 251–259 (2006).
Davis, R. C., Hobbs, F. D. & Lip, G. Y. ABC of heart failure. History and epidemiology. BMJ 320, 39–42 (2000).
Remes, J., Miettinen, H., Reunanen, A. & Pyörälä, K. Validity of clinical diagnosis of heart failure in primary health care. Eur. Heart J. 12, 315–321 (1991).
McKee, P. A. et al. The natural history of congestive heart failure: the Framingham study. N. Engl. J. Med. 285, 1441–1446 (1971).
Di Bari, M. et al. The diagnosis of heart failure in the community. Comparative validation of four sets of criteria in unselected older adults: the ICARe Dicomano Study. J. Am. Coll. Cardiol. 44, 1601–1608 (2004).
Schellenbaum, G. D. et al. Survival associated with two sets of diagnostic criteria for congestive heart failure. Am. J. Epidemiol. 160, 628–635 (2004).
Schellenbaum, G. D. et al. Congestive heart failure incidence and prognosis: case identification using central adjudication versus hospital discharge diagnoses. Ann. Epidemiol. 16, 115–122 (2006).
Goff, D. C., Jr, Pandey, D. K., Chan, F. A., Ortiz, C. & Nichaman, M. Z. Congestive heart failure in the United States: is there more than meets the I(CD code)? The Corpus Christi Heart Project. Arch. Intern. Med. 160, 197–202 (2000).
Higgins, M. W. The Framingham Heart Study: review of epidemiological design and data, limitations and prospects. Prog. Clin. Biol. Res. 147, 51–64 (1984).
Gordis, L. Epidemiology 37–84 (Elsevier/Saunders, Philadelphia, 2009).
Redfield, M. M. et al. Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. JAMA 289, 194–202 (2003).
Mosterd, A. et al. Prevalence of heart failure and left ventricular dysfunction in the general population; The Rotterdam Study. Eur. Heart J. 20, 447–455 (1999).
Kannel, W. B., Ho, K. & Thom, T. Changing epidemiological features of cardiac failure. Br. Heart J. 72, S3–S9 (1994).
Curtis, L. H. et al. Incidence and prevalence of heart failure in elderly persons, 1994–2003. Arch. Intern. Med. 168, 418–424 (2008).
Mosterd, A. & Hoes, A. W. Clinical epidemiology of heart failure. Heart 93, 1137–1146 (2007).
Mendez, G. F. & Cowie, M. R. The epidemiological features of heart failure in developing countries: a review of the literature. Int. J. Cardiol. 80, 213–219 (2001).
Yach, D., Hawkes, C., Gould, C. L. & Hofman, K. J. The global burden of chronic diseases: overcoming impediments to prevention and control. JAMA 291, 2616–2622 (2004).
Yusuf, S., Reddy, S., Ounpuu, S. & Anand, S. Global burden of cardiovascular diseases: Part II: variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation 104, 2855–2864 (2001).
Lloyd-Jones, D. M. et al. Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation 106, 3068–3072 (2002).
Gottdiener, J. S. et al. Predictors of congestive heart failure in the elderly: the Cardiovascular Health Study. J. Am. Coll. Cardiol. 35, 1628–1637 (2000).
Djoussé, L., Kochar, J. & Gaziano, J. M. Secular trends of heart failure among US male physicians. Am. Heart J. 154, 855–860 (2007).
Yusuf, S., Thom, T. & Abbott, R. D. Changes in hypertension treatment and in congestive heart failure mortality in the United States. Hypertension 13, I74–I79 (1989).
Burt, V. L. et al. Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population. Data from the health examination surveys, 1960 to 1991. Hypertension 26, 60–69 (1995).
Bonneux, L., Barendregt, J. J., Meeter, K., Bonsel, G. J. & van der Maas, P. J. Estimating clinical morbidity due to ischemic heart disease and congestive heart failure: the future rise of heart failure. Am. J. Public Health 84, 20–28 (1994).
Hunt, S. A. et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 112, e154–e235 (2005).
Yancy, C. W. Heart failure in African Americans. Am. J. Cardiol. 96, 3i–12i (2005).
Bibbins-Domingo, K. et al. Racial differences in incident heart failure among young adults. N. Engl. J. Med. 360, 1179–1190 (2009).
Goldberg, R. J., Ciampa, J., Lessard, D., Meyer, T. E. & Spencer, F. A. Long-term survival after heart failure: a contemporary population-based perspective. Arch. Intern. Med. 167, 490–496 (2007).
Bleumink, G. S. et al. Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure. The Rotterdam Study. Eur. Heart J. 25, 1614–1619 (2004).
Stewart, S., MacIntyre, K., Hole, D. J., Capewell, S. & McMurray, J. J. More 'malignant' than cancer? Five-year survival following a first admission for heart failure. Eur. J. Heart Fail. 3, 315–322 (2001).
Ni, H., Nauman, D. J. & Hershberger, R. E. Analysis of trends in hospitalizations for heart failure. J. Card. Fail. 5, 79–84 (1999).
Polanczyk, C. A., Rohde, L. E., Dec, G. W. & DiSalvo, T. Ten-year trends in hospital care for congestive heart failure: improved outcomes and increased use of resources. Arch. Intern. Med. 160, 325–332 (2000).
Fonarow, G. C., Adams, K. F., Jr, Abraham, W. T., Yancy, C. W. & Boscardin, W. J. Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis. JAMA 293, 572–580 (2005).
Bueno, H. et al. Trends in length of stay and short-term outcomes among Medicare patients hospitalized for heart failure, 1993–2006. JAMA 303, 2141–2147 (2010).
[No authors listed] Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. The SOLVD Investigators. N. Engl. J. Med. 325, 293–302 (1991).
Ahn, S. A. et al. Early versus delayed enalapril in patients with left ventricular systolic dysfunction: impact on morbidity and mortality 15 years after the SOLVD trial. J. Am. Coll. Cardiol. 47, 1904–1905 (2006).
Lindenfeld, J. et al. HFSA 2010 Comprehensive Heart Failure Practice Guideline. J. Card. Fail. 16, e1–e194 (2010).
Aurigemma, G. P., Zile, M. R. & Gaasch, W. H. Contractile behavior of the left ventricle in diastolic heart failure: with emphasis on regional systolic function. Circulation 113, 296–304 (2006).
Lam, C. S., Donal, E., Kraigher-Krainer, E. & Vasan, R. S. Epidemiology and clinical course of heart failure with preserved ejection fraction. Eur. J. Heart Fail. doi:10.1093/eurjhf/hfq121.
Aurigemma, G. P. & Gaasch, W. H. Clinical practice. Diastolic heart failure. N. Engl. J. Med. 351, 1097–1105 (2004).
Paulus, W. J. et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur. Heart J. 28, 2539–2550 (2007).
Zile, M. R. et al. Heart failure with a normal ejection fraction: is measurement of diastolic function necessary to make the diagnosis of diastolic heart failure? Circulation 104, 779–782 (2001).
Vasan, R. S., Benjamin, E. J. & Levy, D. Prevalence, clinical features and prognosis of diastolic heart failure: an epidemiologic perspective. J. Am. Coll. Cardiol. 26, 1565–1574 (1995).
Owan, T. E. & Redfield, M. M. Epidemiology of diastolic heart failure. Prog. Cardiovasc. Dis. 47, 320–332 (2005).
Lee, D. S. et al. Relation of disease pathogenesis and risk factors to heart failure with preserved or reduced ejection fraction: insights from the Framingham Heart Study of the National Heart, Lung, and Blood Institute. Circulation 119, 3070–3077 (2009).
Bursi, F. et al. Systolic and diastolic heart failure in the community. JAMA 296, 2209–2216 (2006).
Fonarow, G. C. et al. Characteristics, treatments, and outcomes of patients with preserved systolic function hospitalized for heart failure: a report from the OPTIMIZE-HF Registry. J. Am. Coll. Cardiol. 50, 768–777 (2007).
Lenzen, M. J. et al. Differences between patients with a preserved and a depressed left ventricular function: a report from the EuroHeart Failure Survey. Eur. Heart J. 25, 1214–1220 (2004).
Henkel, D. M., Redfield, M. M., Weston, S. A., Gerber, Y. & Roger, V. L. Death in heart failure: a community perspective. Circ. Heart Fail. 1, 91–97 (2008).
Gottdiener, J. S. et al. Outcome of congestive heart failure in elderly persons: influence of left ventricular systolic function. The Cardiovascular Health Study. Ann. Intern. Med. 137, 631–639 (2002).
Setaro, J. F., Soufer, R., Remetz, M. S., Perlmutter, R. A. & Zaret, B. L. Long-term outcome in patients with congestive heart failure and intact systolic left ventricular performance. Am. J. Cardiol. 69, 1212–1216 (1992).
Davis, B. R. et al. Heart failure with preserved and reduced left ventricular ejection fraction in the antihypertensive and lipid-lowering treatment to prevent heart attack trial. Circulation 118, 2259–2267 (2008).
Pfeffer, M. A. et al. Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall programme. Lancet 362, 759–766 (2003).
Somaratne, J. B. et al. The prognostic significance of heart failure with preserved left ventricular ejection fraction: a literature-based meta-analysis. Eur. J. Heart Fail. 11, 855–862 (2009).
Vasan, R. S. et al. Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction: prevalence and mortality in a population-based cohort. J. Am. Coll. Cardiol. 33, 1948–1955 (1999).
Yancy, C. W., Lopatin, M., Stevenson, L. W., De Marco, T. & Fonarow, G. C. Clinical presentation, management, and in-hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function: a report from the Acute Decompensated Heart Failure National Registry (ADHERE) Database. J. Am. Coll. Cardiol. 47, 76–84 (2006).
Solomon, S. D. et al. Influence of nonfatal hospitalization for heart failure on subsequent mortality in patients with chronic heart failure. Circulation 116, 1482–1487 (2007).
Hogg, K., Swedberg, K. & McMurray, J. Heart failure with preserved left ventricular systolic function; epidemiology, clinical characteristics, and prognosis. J. Am. Coll. Cardiol. 43, 317–327 (2004).
Kenchaiah, S., Narula, J. & Vasan, R. S. Risk factors for heart failure. Med. Clin. North Am. 88, 1145–1172 (2004).
He, J. et al. Risk factors for congestive heart failure in US men and women: NHANES I epidemiologic follow-up study. Arch. Intern. Med. 161, 996–1002 (2001).
Chen, Y. T. et al. Risk factors for heart failure in the elderly: a prospective community-based study. Am. J. Med. 106, 605–612 (1999).
Hellermann, J. P. et al. Incidence of heart failure after myocardial infarction: is it changing over time? Am. J. Epidemiol. 157, 1101–1107 (2003).
Fonarow, G. C. et al. Factors identified as precipitating hospital admissions for heart failure and clinical outcomes: findings from OPTIMIZE-HF. Arch. Intern. Med. 168, 847–854 (2008).
Velagaleti, R. S. et al. Long-term trends in the incidence of heart failure after myocardial infarction. Circulation 118, 2057–2062 (2008).
Goldberg, R. J. et al. A 25-year perspective into the changing landscape of patients hospitalized with acute myocardial infarction (the Worcester Heart Attack Study). Am. J. Cardiol. 94, 1373–1378 (2004).
Spencer, F. A. et al. Twenty year trends (1975–1995) in the incidence, in-hospital and long-term death rates associated with heart failure complicating acute myocardial infarction: a community-wide perspective. J. Am. Coll. Cardiol. 34, 1378–1387 (1999).
Guidry, U. C. et al. Temporal trends in event rates after Q-wave myocardial infarction: the Framingham Heart Study. Circulation 100, 2054–2059 (1999).
Ezekowitz, J. A. et al. Declining in-hospital mortality and increasing heart failure incidence in elderly patients with first myocardial infarction. J. Am. Coll. Cardiol. 53, 13–20 (2009).
Levy, D., Larson, M. G., Vasan, R. S., Kannel, W. B. & Ho, K. K. The progression from hypertension to congestive heart failure. JAMA 275, 1557–1562 (1996).
Psaty, B. M. et al. Health outcomes associated with antihypertensive therapies used as first-line agents. A systematic review and meta-analysis. JAMA 277, 739–745 (1997).
Chapman, N. & Neal, B. Prospectively designed overviews of recent trials comparing antihypertensive regimens based on different drug classes. Curr. Hypertens. Rep. 3, 340–349 (2001).
Ingelsson, E., Sundström, J., Arnlöv, J., Zethelius, B. & Lind, L. Insulin resistance and risk of congestive heart failure. JAMA 294, 334–341 (2005).
Kannel, W. B. Incidence and epidemiology of heart failure. Heart Fail. Rev. 5, 167–173 (2000).
Bibbins-Domingo, K. et al. Predictors of heart failure among women with coronary disease. Circulation 110, 1424–1430 (2004).
From, A. M. et al. Diabetes in heart failure: prevalence and impact on outcome in the population. Am. J. Med. 119, 591–599 (2006).
Kronmal, R. A., Cain, K. C., Ye, Z. & Omenn, G. S. Total serum cholesterol levels and mortality risk as a function of age. A report based on the Framingham data. Arch. Intern. Med. 153, 1065–1073 (1993).
Kjekshus, J., Pedersen, T. R., Olsson, A. G., Faergeman, O. & Pyörälä, K. The effects of simvastatin on the incidence of heart failure in patients with coronary heart disease. J. Card. Fail. 3, 249–254 (1997).
Hoffman, R. M., Psaty, B. M. & Kronmal, R. A. Modifiable risk factors for incident heart failure in the coronary artery surgery study. Arch. Intern. Med. 154, 417–423 (1994).
Suskin, N., Sheth, T., Negassa, A. & Yusuf, S. Relationship of current and past smoking to mortality and morbidity in patients with left ventricular dysfunction. J. Am. Coll. Cardiol. 37, 1677–1682 (2001).
Judge, K. W., Pawitan, Y., Caldwell, J., Gersh, B. J. & Kennedy, J. W. Congestive heart failure symptoms in patients with preserved left ventricular systolic function: analysis of the CASS registry. J. Am. Coll. Cardiol. 18, 377–382 (1991).
Kitzman, D. W. et al. Importance of heart failure with preserved systolic function in patients ≥65 years of age. CHS Research Group. Cardiovascular Health Study. Am. J. Cardiol. 87, 413–419 (2001).
Kenchaiah, S. et al. Obesity and the risk of heart failure. N. Engl. J. Med. 347, 305–313 (2002).
Goldberg, R. J., Spencer, F. A., Farmer, C., Meyer, T. E. & Pezzella, S. Incidence and hospital death rates associated with heart failure: a community-wide perspective. Am. J. Med. 118, 728–734 (2005).
Curtis, J. P. et al. The obesity paradox: body mass index and outcomes in patients with heart failure. Arch. Intern. Med. 165, 55–61 (2005).
Kalantar-Zadeh, K., Block, G., Horwich, T. & Fonarow, G. C. Reverse epidemiology of conventional cardiovascular risk factors in patients with chronic heart failure. J. Am. Coll. Cardiol. 43, 1439–1444 (2004).
Djoussé, L., Kurth, T. & Gaziano, J. M. Cystatin C and risk of heart failure in the Physicians' Health Study (PHS). Am. Heart J. 155, 82–86 (2008).
Bibbins-Domingo, K. et al. Renal insufficiency as an independent predictor of mortality among women with heart failure. J. Am. Coll. Cardiol. 44, 1593–1600 (2004).
Schocken, D. D. et al. Prevention of heart failure: a scientific statement from the American Heart Association Councils on Epidemiology and Prevention, Clinical Cardiology, Cardiovascular Nursing, and High Blood Pressure Research; Quality of Care and Outcomes Research Interdisciplinary Working Group; and Functional Genomics and Translational Biology Interdisciplinary Working Group. Circulation 117, 2544–2565 (2008).
Cleland, J. G. et al. Management of heart failure in primary care (the IMPROVEMENT of Heart Failure Programme): an international survey. Lancet 360, 1631–1639 (2002).
Masoudi, F. A. & Krumholz, H. M. Polypharmacy and comorbidity in heart failure. BMJ 327, 513–514 (2003).
Havranek, E. P. et al. Spectrum of heart failure in older patients: results from the National Heart Failure project. Am. Heart J. 143, 412–417 (2002).
Braunstein, J. B. et al. Noncardiac comorbidity increases preventable hospitalizations and mortality among Medicare beneficiaries with chronic heart failure. J. Am. Coll. Cardiol. 42, 1226–1233 (2003).
DeFrances, C. J., Lucas, C. A., Buie, V. C. & Golosinskiy, A. 2006 National Hospital Discharge Survey. Natl Health Stat. Report 5, 1–20 (2008).
Stewart, S. et al. Trends in hospitalization for heart failure in Scotland, 1990–1996. An epidemic that has reached its peak? Eur. Heart J. 22, 209–217 (2001).
McMurray, J., McDonagh, T., Morrison, C. E. & Dargie, H. J. Trends in hospitalization for heart failure in Scotland 1980–1990. Eur. Heart J. 14, 1158–1162 (1993).
Page, J. & Henry, D. Consumption of NSAIDs and the development of congestive heart failure in elderly patients: an underrecognized public health problem. Arch. Intern. Med. 160, 777–784 (2000).
Jencks, S. F., Williams, M. V. & Coleman, E. A. Rehospitalizations among patients in the Medicare fee-for-service program. N. Engl. J. Med. 360, 1418–1428 (2009).
Feldman, D. E. et al. Changing trends in mortality and admissions to hospital for elderly patients with congestive heart failure in Montreal. CMAJ 165, 1033–1036 (2001).
Fonarow, G. C., Yancy, C. W. & Heywood, J. T. Adherence to heart failure quality-of-care indicators in US hospitals: analysis of the ADHERE Registry. Arch. Intern. Med. 165, 1469–1477 (2005).
O'Connell, J. B. & Bristow, M. R. Economic impact of heart failure in the United States: time for a different approach. J. Heart Lung Transplant. 13, S107–S112 (1994).
Chan, P. S. et al. Patient health status and costs in heart failure: insights from the eplerenone post-acute myocardial infarction heart failure efficacy and survival study (EPHESUS). Circulation 119, 398–407 (2009).
Hernandez, A. F. et al. Relationship between early physician follow-up and 30-day readmission among Medicare beneficiaries hospitalized for heart failure. JAMA 303, 1716–1722 (2010).
Muus, K. J. et al. Effect of post-discharge follow-up care on re-admissions among US veterans with congestive heart failure: a rural-urban comparison. Rural Remote Health 10, 1447 (2010).
Liao, L., Allen, L. A. & Whellan, D. J. Economic burden of heart failure in the elderly. Pharmacoeconomics 26, 447–462 (2008).
Stewart, S. et al. The current cost of heart failure to the National Health Service in the UK. Eur. J. Heart Fail. 4, 361–371 (2002).
Liao, L. et al. Costs for heart failure with normal vs reduced ejection fraction. Arch. Intern. Med. 166, 112–118 (2006).
Lee, W. C., Chavez, Y. E., Baker, T. & Luce, B. R. Economic burden of heart failure: a summary of recent literature. Heart Lung 33, 362–371 (2004).
Stewart, S., MacIntyre, K., Capewell, S. & McMurray, J. J. Heart failure and the aging population: an increasing burden in the 21st century? Heart 89, 49–53 (2003).
Phillips, C. O. et al. Comprehensive discharge planning with postdischarge support for older patients with congestive heart failure: a meta-analysis. JAMA 291, 1358–1367 (2004).
Inglis, S. C. et al. Extending the horizon in chronic heart failure: effects of multidisciplinary, home-based intervention relative to usual care. Circulation 114, 2466–2473 (2006).
Michalsen, A., König, G. & Thimme, W. Preventable causative factors leading to hospital admission with decompensated heart failure. Heart 80, 437–441 (1998).
A. L. Bui is supported by the NIH Kirschstein-NRSA fellowship. T. B. Horwich is a recipient of NIH/NHLBI 1K23HL085097. G. C. Fonarow holds the Eliot Corday Chair in Cardiovascular Medicine and Science and is also supported by the Ahmanson Foundation.
G. C. Fonarow has worked as a consultant for Novartis, and received speaker's bureau honoraria from GlaxoSmithKline, Merck, Bristol-Myers Squibb/Sanofi, Pfizer, and Medtronic. A. L. Bui and T. B. Horwich declare no competing interests.
About this article
Cite this article
Bui, A., Horwich, T. & Fonarow, G. Epidemiology and risk profile of heart failure. Nat Rev Cardiol 8, 30–41 (2011). https://doi.org/10.1038/nrcardio.2010.165
Advanced NanoBiomed Research (2021)
Frontiers in Cardiovascular Medicine (2021)
Factors related to the discontinuation and mortality rates of a cardiac rehabilitation programme in patients with Chagas disease: a 6‐year experience in a Brazilian tertiary centre
Tropical Medicine & International Health (2021)
Bioactive decellularized cardiac extracellular matrix-based hydrogel as a sustained-release platform for human adipose tissue-derived stromal cell-secreted factors
Biomedical Materials (2021)
Effects of Sodium/Glucose Cotransporter 2 (SGLT2) Inhibitors on Cardiovascular and Metabolic Outcomes in Patients Without Diabetes Mellitus: A Systematic Review and Meta‐Analysis of Randomized‐Controlled Trials
Journal of the American Heart Association (2021)