More people around the world are at risk of heart failure

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Up to 2% of adults in Europe, North America and Israel are likely to have heart failure, which carries a high risk of additional serious complications and death. Such a high prevalence, associated health risks and the costs require urgent action, say researchers at the Academy of Medical Sciences.

The new estimates were based on digital medical records from 11 countries and published online in the journal Heart. The researchers conducted the CardioRenal and Metabolic Disease (CaReMe) Heart Failure Study to estimate prevalence, major adverse outcomes, and costs for Sweden, Norway, UK, Belgium, Germany, Switzerland, Italy, Spain, Portugal, Israel, and Canada.

Heart failure has been broadly defined as any reported diagnosis of heart failure, but strictly defined as the need for hospitalization due to this condition. The mean age of patients in the study was 75 years; 45% of them are women.

Approximately 42% of patients with heart failure had preserved left ventricular ejection fraction. Nearly half (49%) of patients with heart failure had coronary artery disease; 44% have irregular heart rhythms and just over a third (34.5%) have diabetes. Of the 170,000 people with heart failure who had their kidney function measured, half had moderate to severe chronic kidney disease.

Based on their data, the researchers calculated that the adult prevalence of heart failure was 2% using the broad definition and 1% using the strict definition across all 11 countries and more than 32 million people.

Highest prevalence (broad definition) was in Portugal (just under 3%); the lowest is in the UK (almost 1.5%). The risk of annual hospitalization was highest for people with heart failure and chronic kidney disease (19%) and lower for people with other cardiovascular diseases such as heart attack (3%), stroke (2%) and peripheral artery disease (1 %). The annual death rate was 13%.

These figures indicate that preventive care should be focused primarily on stopping the deterioration of heart failure and kidney function, the researchers say.

Hospital care costs, which were obtained from six countries and 462,825 patients, was the highest for those with both heart and kidney disease, and higher than the costs caused by coronary heart disease and stroke.

Heart failure affects millions of people worldwide, but the number of cases is expected to rise as the population ages and diagnostics improve, they note. This is a costly disease: in Europe and the United States, 1 to 2% of the annual health care budget is allocated for its treatment.

This was an observational study, and the researchers note that the results may not be applicable to other races or people with other resources and access to healthcare.

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