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The epidemiology of heart failure: the Framingham Study
K K Ho1, J L Pinsky, W B Kannel
1Charles A. Dana Research Institute, Boston, Massachusetts.
Insights
Congestive heart failure (CHF) is a growing health concern, particularly in older adults and men. Despite advances, CHF incidence has only slightly declined, and survival rates remain poor.
Area of Science:
- Cardiology
- Public Health
Background:
- Congestive heart failure (CHF) is a significant and increasing cause of hospitalizations.
- Its incidence rises with age and is more prevalent in men.
- Hypertension, coronary heart disease, diabetes mellitus, and left ventricular hypertrophy are key risk factors.
Purpose of the Study:
- To analyze the incidence, prevalence, and survival rates of congestive heart failure.
- To assess trends in CHF over a 40-year observation period.
- To evaluate the impact of improved treatments on CHF outcomes.
Main Methods:
- Utilized data from the Framingham Heart Study.
- Analyzed age-adjusted incidence and prevalence rates from the 1980s.
- Examined survival times and rates over a 40-year period.
Main Results:
- In the 1980s, CHF incidence was 7.2/1,000 in men and 4.7/1,000 in women (aged >=45).
- Prevalence was 24/1,000 in men and 25/1,000 in women.
- Despite treatment improvements, incidence declined only 11% (men) and 17% (women) per decade.
- Median survival: 1.7 years (men), 3.2 years (women); 5-year survival: 25% (men), 38% (women).
Conclusions:
- Congestive heart failure remains a major public health issue with limited improvement in incidence.
- CHF continues to have a high mortality rate, with significantly poorer survival in men.
- Further advancements in prevention and treatment strategies are crucial.
Abstract:
Congestive heart failure has become an increasingly frequent reason for hospital admission during the last 2 decades and clearly represents a major health problem. Data from the Framingham Heart Study indicate that the incidence of congestive heart failure increases with age and is higher in men than in women. Hypertension and coronary heart disease are the two most common conditions predating its onset. Diabetes mellitus and electrocardiographic left ventricular hypertrophy are also associated with an increased risk of heart failure. During the 1980s, the annual age-adjusted incidence of congestive heart failure among persons aged > or = 45 years was 7.2 cases/1,000 in men and 4.7 cases/1,000 in women, whereas the age-adjusted prevalence of overt heart failure was 24/1,000 in men and 25/1,000 in women. Despite improved treatments for ischemic heart disease and hypertension, the age-adjusted incidence of heart failure has declined by only 11%/calendar decade in men and by 17%/calendar decade in women during a 40-year period of observation. In addition, congestive heart failure remains highly lethal, with a median survival time of 1.7 years in men and 3.2 years in women and a 5-year survival rate of 25% in men and 38% in women.