Trends in heart failure prevalence in Japan 2014-2019: a report from healthcare administration databases

Contemporary estimates of heart failure (HF) prevalence in Japan are scarce. We aimed to estimate HF prevalence and trends in Japan using nationally representative, large administrative claims databases.

This retrospective analysis used data from the Japan Medical Data Center (JMDC) (age ≤74 years) and the Medical Data Vision (MDV) (all ages) databases (study period: 1 January 2014-31 December 31 2019). We calculated HF prevalence using crude and sex-/age-standardized models (weighting based on Japanese census data, 2014-2019). Among 8 954 313 individuals aged ≤74 years from JMDC, and 27 920 174 of all ages from MDV, the cumulative 6 year (2014-2019) crude and sex-/age-standardized prevalence of HF per 1000 persons (95% confidence intervals) in Japan was 21.80 [21.70, 21.89] and 41.79 [30.25, 56.11] using JMDC and 65.09 [65.00, 65.18] and 60.95 [46.94, 77.62], respectively, using MDV. We observed an increasing yearly trend in crude HF prevalence per 1000 persons: 11.12 in 2014 and 14.69 in 2019 for JMDC; 58.09 and 77.18, respectively, for MDV. There was an overall increasing trend of comorbidities over time (2014-2019) among HF patients, especially in type 2 diabetes, malignant cancer, chronic kidney disease, and atrial fibrillation. From 2014 to 2019, the percentage of patients in JMDC with type 2 diabetes increased from 15.4% to 20.8% and 23.4% to 31.5% in MDV; malignant cancer frequency increased from 16.5% to 20.1% in JMDC and 18.8% to 23.9% in MDV; frequency of chronic kidney disease increased from 14.8% to 17.7% in JMDC and 18.2% to 22.7% in MDV; and frequency of atrial fibrillation increased from 13.6% to 15.6% in JMDC and 23.8% to 29.0% in MDV.

We estimated that the prevalence of HF in Japan was 2.2-3.7% for patients aged ≤74 during the period 2014-2019 using the JMDC database, while the prevalence for patients of all ages was 6.5% using the MDV database.