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Published on: June 10, 2025
The aging burden of hospitalization for heart failure in Chinese populations: evidence from the Macao Heart Failure
Zhi-Nan Lu1, Mario Evora2, Edmundo Lao2
1Coronary Heart Disease Center, Cardiology Department, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Insights
Hospitalization for heart failure (HF) disproportionately affects the elderly in Macao, driven by economic growth and an aging population. Significant variations in HF characteristics and outcomes among age groups necessitate age-specific care strategies.
Area of Science:
- Cardiology
- Geriatrics
- Public Health
Background:
- Macao's rapid economic development and aging population structure present unique challenges for healthcare.
- Heart failure (HF) is a significant public health concern, particularly among older adults.
Purpose of the Study:
- To assess the burden of hospitalization for heart failure in Chinese populations in Macao.
- To investigate the relationship between socioeconomic development and HF epidemiology.
- To analyze clinical features and outcomes of HF patients across different age groups.
Main Methods:
- Retrospective analysis of 967 patients hospitalized with acute heart failure (AHF) from 2014-2016 at Macao's sole public hospital.
- Examination of socioeconomic factors and demographic data.
- Comparison of clinical characteristics, treatment, and outcomes based on patient age.
Main Results:
- The median age of HF admission was 82 years.
- Advanced age at HF admission correlated with higher income and an aging population.
- Significant heterogeneity was observed in HF epidemiology, clinical presentation, treatment, and outcomes across age groups.
Conclusions:
- Acute decompensated heart failure (ADHF) is primarily a geriatric condition in Macao.
- Heterogeneity in clinical features, management, and outcomes necessitates tailored approaches for different age demographics.
- Development of age-based risk stratification and multidisciplinary HF teams is crucial for improving patient care and outcomes.
Objective:
To assess the aging burden of hospitalization for heart failure in Chinese populations in Macao.
Methods:
The Macao Heart Failure Study consists of patients hospitalized with a diagnosis of acute heart failure (AHF) at Centro Hospitalar Conde de São Januário (the only public hospital that provides medical care for the approximately 600, 000 residents of Macao) from January 2014 to December 2016. First, we investigated the relationship between socioeconomic development and epidemiological characteristics of HF in Macao. Then we assessed the patientso clinical features and outcomes according to the age groups.
Results:
A total of 967 patients were included in the final analysis. The median age at admission was 82 years old. The advanced age at the admission of HF in Macao was significantly associated with a high-income level and the aging population structure. Marked heterogeneity existed in the epidemiological characteristics, clinical features, utilization of evidence-based therapies, short- and long-term outcomes, and prognostic utility of clinical variables among the different age groups.
Conclusion:
Rapid economic development and significantly aging populations have produced a profound impact on the epidemiological characteristics of HF in Chinese populations. Acute decompensated heart failure (ADHF) is predominantly a disease of the elderly in Macao, and a significant heterogeneity exists in the clinical features, managements, and outcomes among different age groups. Age-based risk stratification models and multidisciplinary HF teams are urgently needed to improve the management and outcomes of hospitalized heart failure (HHF) patients.
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