Trends in Heart Failure Incidence and Survival in a Community-Based Population

Abstract

The burden of heart failure and its societal cost are staggering. Approximately 4.9 million Americans have been diagnosed with the disease.¹ Hospital discharges for heart failure increased by 155% during the last 20 years, and heart failure is the most frequent cause of hospitalization in persons aged 65 years or older. Within this context, heart failure constitutes a public health problem¹ singled out as an emerging epidemic.² Although the clinical and public health importance of heart failure is undisputed, this epidemic is not adequately understood. Data on the incidence of heart failure are relatively sparse and lack consistency. Most data are derived from hospital discharge records or self-report and thus do not reflect incidence, have uncertain validity caused by documented shifts in coding practices because of reimbursement incentives,³ and cannot fully capture the burden of the disease because of the shift of care toward outpatient settings. Thus, little is known about temporal trends in the incidence of heart failure and on survival after its onset.