What we know about epidemiology of heart failure in Slovakia and globally

Heart failure (HF) is nowadays some of the most significant causes of mortality and morbidity, as well as one of the leading causes of hospitalization. Increasing number of patients with HF is becoming one of the most burning problems not only for health care, but also for the social welfare system. The knowledge of the epidemiology is crucial for rational planning and management of curative and preventive health care and allocation of research capacities. The sources of data for description of basic epidemiological characteristic of HF in Slovakia come from cross sectional surveys of outpatient care and hospitalization records of patients with heart failure, publicized sources of the National health information center and database of health care provision gathered by health insurer Dôvera. Crude prevalence of HF in Slovakia is 2.3%. Age specific prevalence ranging from 31/1 000 in habitants aged 50-54 up to 189/1 000 in the 80-84 age group. Average age in male population was 61.8 (± 8) and women 65.6 (± 9.3) years. In the functional class NYNA I were 10 %, in class NYHA II 45%, NYHA III 32% a NYHA IV 3 % patients with chronic heart failure. The most prevalent dominant cause of HF, 50-60 % of cases, is ischemic heart disease. Left ventricular ejection fraction of less than 40 % was observed in 26 % of patients followed up in general practice and 43 % of patients in care of the specialists. The exact data on HF incidence in Slovakia are no available. Incidence of hospitalizations for the newly diagnosed HF was 120 in one hundred thousand people a year, which could be considered bottom limit of incidence. The number of hospitalizations for HF grows dramatically from 9 060 in 2005 to 22 112 in 2017. The average length of hospitalization in 2015 was 9.4 ± 9.7 days. Hospitalization mortality, despite trend to decline, remains high at 6.2 %. It is estimated that prevalence of chronic HF will grow further fueled by population aging, the treatment success of acute cardiovascular and congenital heart diseases, prevention of sudden heart failure, and also prolongation of life expectancy in patients with HF. Both material and human in health care resources need to adapt to this visible trend. Key words: heart failure - hospitalizations - incidence - prevalence.