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Epidemiology and aetiology of heart failure

Key Points

  • Heart failure (HF) is the most rapidly growing cardiovascular condition globally

  • HF with preserved ejection fraction accounts for an increasing portion of HF in the developed world, and therapies to improve health outcomes are needed

  • Improvement in the primary prevention of cardiovascular disease and the treatment of ischaemic heart disease have reduced the age-adjusted prevalence of HF in the developed world

  • Advances in HF treatment and prevention have resulted in a decline in mortality in developed nations

Abstract

Heart failure (HF) is a rapidly growing public health issue with an estimated prevalence of >37.7 million individuals globally. HF is a shared chronic phase of cardiac functional impairment secondary to many aetiologies, and patients with HF experience numerous symptoms that affect their quality of life, including dyspnoea, fatigue, poor exercise tolerance, and fluid retention. Although the underlying causes of HF vary according to sex, age, ethnicity, comorbidities, and environment, the majority of cases remain preventable. HF is associated with increased morbidity and mortality, and confers a substantial burden to the health-care system. HF is a leading cause of hospitalization among adults and the elderly. In the USA, the total medical costs for patients with HF are expected to rise from US$20.9 billion in 2012 to $53.1 billion by 2030. Improvements in the medical management of risk factors and HF have stabilized the incidence of this disease in many countries. In this Review, we provide an overview of the latest epidemiological data on HF, and propose future directions for reducing the ever-increasing HF burden.

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Figure 1: Incidence of heart failure in Olmsted County between 2000 and 2010.
Figure 2: Global cost of HF per capita in 2012.

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Acknowledgements

B.Z. is supported by the NIH Cardiovascular Scientist Training Program (T32 HL007895).

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Correspondence to Gregg C. Fonarow.

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G.C.F. declares that he has received grants from the AHRQ and NIH, and is a consultant for Amgen, Baxter, Bayer AG, Janssen Pharmaceuticals, Medtronic, and Novartis. B.Z. declares no competing interests.

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Ziaeian, B., Fonarow, G. Epidemiology and aetiology of heart failure. Nat Rev Cardiol 13, 368–378 (2016). https://doi.org/10.1038/nrcardio.2016.25

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