Epidemiology of Incident Heart Failure in a Contemporary Elderly Cohort

Abstract

Heart failure (HF) is primarily a disease of older persons, with an annual incidence of 10 cases per 1000 after age 65 years, which doubles every decade thereafter.¹ Subjects older than 65 years represent more than 75% of prevalent HF cases in the United States.² In a 2004 European study,³ participants older than 70 years accounted for 88% of new HF cases. Although some recent data suggest relative improvement in survival after development of HF,^4,5 other evidence challenges this finding, especially in older persons.⁶ Nevertheless, the absolute survival rate for these patients remains poor, and the actual number of HF deaths has increased by 20.5% during the last decade, reflecting the increasing prevalence of HF and the aging of the population. In patients older than 67 years, the median survival is generally less than 3 years after hospitalization for HF.^7,8 The annual hospitalization rate for these patients now exceeds 1 million in the United States, 80% of patients hospitalized with HF are older than 65 years, and readmission rates as high as 50% within 6 months of discharge have been reported.⁹