Heart Failure Rates on the Rise

Byron's Comments:

The rates rise in conjunction with widespread statin use, although this correlation was not tested in the study.

Study Title:

Hospitalizations For Heart Failure Among Seniors Rising In The US

Study Abstract:

From press release:

The number of older patients hospitalized for heart failure in the US has more than doubled in the last 27 years, which is perhaps not surprising considering that America’s population is aging and more people survive heart attacks and heart disease.

These findings were presented by study author Dr Longjian Liu, associate professor of Epidemiology and Biostatistics of the Drexel University School of Public Health in Philadelphia, at the American Heart Association’s (AHA) Scientific Sessions 2008 in New Orleans over the weekend.

Liu found that the number of patients over the age of 65 hospitalized for heart failure in the US between 1980 and 2006 went up by 131 per cent. He also found the rate was higher among women than men and that the other two major forms of cardiovascular disease, coronary heart disease and stroke, did not show a significant increase in hospitalization rates.

Liu, who is the first to research US heart failure hospitalization rates over the last 27 years, said that that the prevention and treatment of heart failure was an urgent public health need “with national implications”.

“Both the number of patients hospitalized with a primary diagnosis of heart failure and age-adjusted hospitalization rates for heart failure have increased dramatically over the past 27 years,” said Liu.

Heart failure is when any part of the heart muscle becomes so weak that the heart can’t pump enough oxygen and nutrient-rich blood to the cells of the body. A person with heart failure feels fatigued and experiences shortness of breath and they struggle to get just through the day.

According to the AHA about 5.3 million people are living with heart failure in the US, where about 660,000 Americans are diagnosed with the condition every year.

For the study Liu accessed nationally representative data from 1980 to 2006 covering 2.2 million patients aged 65 recorded in the National Hospital Discharge Surveys. He searched for data on patients with a primary diagnosis of heart failure at hospital discharge and broke it down by gender and age into three age groups: 65 to 74, 75 to 85, and 85 and above. He then used census population data and statistical methods to estimate national hospitalization rates in terms of gender and time periods.

The estimates he produced suggested that:
The number of patients aged 65 and older who were hospitalized for heart failure went up from 348,866 in 1980 to 807,082 in 2006.

This a rise of 131 per cent over the 27 years.

Among men, the hospitalizations went up from 16.57 per 1,000 in 1980 to 22.87 in 2006.

Among women, the hospitalizations went up from 13.95 per 1,000 in 1980 to 19.58 in 2006.

The annual percentage increase among women was significantly higher than for men (55 versus 20 per cent).

The relative risk of being hospitalized due to heart failure was 1.37 times higher in 2002 to 2006 than it was in 1980 to 1984.

Patients aged between 75 and 84 were twice as likely to be hospitalized for heart failure than those between 65 and 74.

Patients aged 85 and over had four times more risk of being hospitalized for heart failure than patients aged 65 to 74.

Among the three major forms of cardiovascular disease, hospitalization rates of coronary heart disease and stroke have gone down since the mid 1980s.

This compares with a continuous and significant rise in hospitalization rates for heart failure since that time.
Liu said the crisis had not yet reached its peak and will probably rise further over the next decade or so, because the number of seniors aged 65 and older in the US is set to double to 70 million by the year 2030 when more than one in five Americans will be 65 or over.

“Because heart failure disproportionately affects the elderly, there is no doubt that the burden of heart failure will increase unless innovative strategies are implemented. The key is to prevent risk factors for the disease,” added Liu.

The risk factors for heart failure include lifestyle factors such as smoking, physical inactivity and a diet rich in fatty foods. They also include diseases like coronary heart disease, chronic obstructive pulmonary disease, valvular heart disease, diabetes, obesity, stroke and high blood pressure. Liu said that preventing chronic kidney disease and pneumonia would also reduce heart failure risk.

“Heart failure hospitalization rates rise among nation’s seniors.”
Longjian Liu.
Abstract 3103, presented at the American Heart Association’s (AHA) Scientific Sessions 2008 in New Orleans on 9 November 2008.

Study Information:

Longjian Liu. Hospitalizations For Heart Failure Among Seniors Rising In The US American Heart Association's (AHA) Scientific Sessions 2008 in New Orleans. 2008 November 
Epidemiology and Biostatistics of the Drexel University School of Public Health in Philadelphia.

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