Abstract 3104: Heart Failure: Is there an Epidemic? A 17-Year Longitudinal Study on the Incidence, Prevalence and Survival Outcomes

Background Despite concerns of a heart failure ‘epidemic’, long term population trends on the incidence, prevalence and survival outcomes of heart failure (HF) are not well characterized. Methods The Western Australian Hospital Morbidity Database was used to identify index patients with first-time admissions for HF from 1990 to 2006, with no prior admission for HF since 1 January 1980. Age and gender adjusted temporal trends in HF incidence were examined and Cox-proportional hazards model used to analyse 5-year survival following index admissions, adjusted for significant covariates. Prevalence was calculated at end of each calendar year. Base period used was 1990–1993. Results There were 70,967 index heart failure (HF) patients identified during 1990–2006, with almost equal distribution between genders. There was a significant downward trend for age and gender-adjusted incidence of HF with average decline of 1.73% (95% CI 1.5%, 1.9%, p=0.001) per year over the 17-year period. Incidence rate reached a peak in 1993 and thereafter there was a steady decline. Compared to the base period, age and gender-adjusted survival at 5-year after index HF admission improved with an absolute survival gain of 6.9% (95% CI 4.3%, 9.4% p=0.001) for 1994–97 period, 9.3% (95% CI 6.7%, 11.9%, p=0.001) for 1998–2001 period and 7.0% (95% CI 4.1%, 9.8%, p=0.001) for 2002– 05 period respectively. Prevalence of HF increased significantly over the different time periods, with a 2.26 fold higher prevalence in 2002–2006 compared to base period. The increase in prevalence was greatest in the 70–79 year age group, with an increase from 200.3 per 10,000 in the base period to 606.0 per 10,000 in 2002–2006. Conclusions In the last 17 years, incidence of hospitalized HF patients has declined steadily in both genders. However, there has been a marked increase in prevalence of HF due in part to an ageing population and improved HF survival. Management of these chronic elderly HF patients remains a major public health problem.

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Sleep Disordered Breathing, Insomnia, and Health Related Quality of Life — A Comparison Between age and Gender Matched Elderly with Heart Failure or Without Cardiovascular Disease

European Journal of Cardiovascular Nursing ◽

10.1016/j.ejcnurse.2009.11.005 ◽

2010 ◽

Vol 9 (2) ◽

pp. 108-117 ◽

Cited By ~ 23

Author(s):

Peter Johansson ◽

Kristoffer Årestedt ◽

Urban Alehagen ◽

Eva Svanborg ◽

Ulf Dahlström ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Cardiovascular Disease ◽

Sleep Disordered Breathing ◽

Health Related Quality ◽

Age And Gender ◽

Related Quality ◽

Health Related ◽

And Gender

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Age and gender differences in physical heart failure symptom clusters

Heart & Lung ◽

10.1016/j.hrtlng.2021.07.001 ◽

2021 ◽

Vol 50 (6) ◽

pp. 832-837

Author(s):

Kristen A. Sethares ◽

Elizabeth Chin

Keyword(s):

Heart Failure ◽

Gender Differences ◽

Symptom Clusters ◽

Age And Gender ◽

Heart Failure Symptom ◽

Age And Gender Differences ◽

And Gender

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Comparison between ATS/ERS age- and gender-adjusted criteria and GOLD criteria for the detection of irreversible airway obstruction in chronic heart failure

Clinical Research in Cardiology ◽

10.1007/s00392-012-0438-0 ◽

2012 ◽

Vol 101 (8) ◽

pp. 637-645 ◽

Cited By ~ 12

Author(s):

Richard Steinacher ◽

John T. Parissis ◽

Bernhard Strohmer ◽

Jörg Eichinger ◽

Dennis Rottlaender ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Airway Obstruction ◽

Age And Gender ◽

And Gender ◽

Irreversible Airway Obstruction

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Abstract 16247: Methamphetamine Use Predicts Worse Prognosis in a Safety Net Heart Failure Population

Circulation ◽

10.1161/circ.142.suppl_3.16247 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Anjali B Thakkar ◽

Yifei Ma ◽

Teresa Wang ◽

Alexandra Teng ◽

Rebecca Scherzer ◽

...

Keyword(s):

Heart Failure ◽

Coronary Artery ◽

San Francisco ◽

Cox Regression ◽

Bypass Graft ◽

Safety Net ◽

High Risk Population ◽

Age And Gender ◽

Safety Net Hospital ◽

And Gender

Background: Methamphetamine (MA) use is rising, and overdose deaths have increased by 500% in San Francisco since 2008. MA use is associated with heart failure (HF); yet, cardiovascular (CV) outcomes in this population have not been described. Methods: We performed a retrospective case-control study of HF patients at a safety net hospital in San Francisco. Between January 2001-June 2019, 1771 HF patients with MA use were matched by age and gender to 3542 HF patients without MA use. We examined age and gender-adjusted associations of MA use with likelihood of index HF admission and 30-day readmission (HF and all-cause), and used demographic-adjusted Cox regression model with competing risks to compare hazard rates associated with MA use over the 18-year study period. Results: At time of HF diagnosis, mean age was 52 years and 77% were male. Patients with MA use were significantly more likely than non-MA users to be black (49.1% vs 33.0%), and to have comorbid conditions including HIV (14.5% vs 4.7%), pulmonary hypertension (11.1% vs 7.7%), hypertension (82.0% vs 77.6%), and cocaine use (58.0% vs 14.7%). Despite similar rates of coronary artery disease, myocardial infarction, and diabetes, HF patients with MA use were less likely to have percutaneous coronary intervention (6.1% vs 8.2%) or coronary artery bypass graft (0.8% vs 1.4%), p<0.05 for all. Compared to HF patients without MA use, HF patients with MA use had higher rates of index HF hospitalizations (36.0% vs 21.7%, adjusted odds ratio 2.04, 95% CI 1.80-2.32, p<0.01), 30-day HF readmission (12.2% vs 6.4%, adjusted hazard ratio (aHR) 1.87, 95% CI 1.31-2.67, p<0.01) and 30-day all cause readmission (20.9% vs 14.3%, aHR 1.46, 95% CI 1.14-1.88, p<0.01). Exposure to MA was associated with higher likelihood of death during the study period, regardless of hospitalizations (22.4% vs 15.1%, aHR=1.17, 95% CI 1.03-1.33, p<0.01). Conclusions: In our study, HF patients with MA use were more likely to be admitted for an index HF admission; subsequently, they were also more likely to be readmitted within 30 days. Regardless of hospitalization risk, individuals with MA use had higher likelihood of death. Further study to understand the clinical and socioeconomic factors driving worse outcomes in this high-risk population is needed.

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Associations between mental illnesses and acute cardiovascular events and cancers in France in 2016

European Journal of Public Health ◽

10.1093/eurpub/ckz187.194 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

T Lesuffleur ◽

M Coldefy ◽

A Rachas ◽

C Gastaldi-Ménager ◽

P Tuppin

Keyword(s):

Heart Failure ◽

Mental Illness ◽

Pulmonary Embolism ◽

General Population ◽

Cardiovascular Events ◽

Healthcare Professionals ◽

Mental Illnesses ◽

Age And Gender ◽

Addictive Disorder ◽

And Gender

Abstract Background People with a mental illness have higher risks of somatic diseases and higher mortality, but this has been poorly documented in France. We studied the associations between mental illnesses and acute cardiovascular events (ACEs) and cancers in the French national health data system (SNDS). Methods We included all health insurance general scheme beneficiaries ≥18 years-of-age in 2016. Mental illnesses (psychotic disorder, neurotic or mood disorder, mental retardation and addictive disorder), ACEs (acute coronary syndrome (ACS), stroke, acute heart failure and pulmonary embolism) and cancers (breast, colorectal, lung and prostate) were identified using algorithms based on long-term disease registry, hospitalization diagnoses and specific drug deliveries. The associations were measured using morbidity ratios standardized by age and gender when appropriate (SMRs). Results ACEs were more frequent in the subjects with a mental illness than in the general population: ACS (SMR: 1.6), stroke (2.3), acute heart failure (1.9), pulmonary embolism (2.4). Similar results were found for each mental illness, except for ACS, which were less frequent in those with a mental retardation (SMR: 0.5) and were not associated with psychotic disorder (SMR: 1.0). Mental illness was also associated with more frequent breast (SMR: 1.3), colorectal (1.3), lung (2.0) and prostate (1.2) cancers, in particular for those with a neurotic or mood disorder (SMRs: 1.3, 1.5, 2.3, 1.2, respectively) and, for lung cancer, those with an addictive disorder (SMR: 2.6). Conclusions Globally, ACEs and cancers were more frequent in patients with a mental illness relative to the general population after standardization by age and gender, which could be related to adverse effects of certain psychotropic drugs or behaviours or risk factors related to the mental illness. Healthcare professionals should be aware of this to more adequately account for the specificities of the patients with a mental illness. Key messages ACEs and cancers were more frequent in patients with a mental illness relative to the general population after standardization by age and gender. Healthcare professionals should be aware of this to more adequately account for the specificities of the patients with a mental illness.

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Temporal trends in incidence of heart failure in relation to age and gender in western Sweden 2008–2017

European Heart Journal ◽

10.1093/ehjci/ehaa946.0972 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Wideqvist ◽

A Rosengren ◽

M Schaufelberger ◽

A Pivodic ◽

M Fu

Keyword(s):

Heart Failure ◽

Adult Population ◽

Temporal Trends ◽

Administrative Database ◽

Funding Source ◽

Age And Gender ◽

Development Fund ◽

The Government ◽

And Gender ◽

Incident Cases

Abstract Background During the last decades we have witnessed gradually improved cardiovascular primary and secondary prevention, while life expectancy is increasing, with a growing population of elderly people. Heart failure is a disease of the elderly and end stage of other cardiac diseases. Accordingly, trends in incidence of heart failure are dynamic and may differ by age and gender Purpose To investigate overall trends in incidence for HF over the last decades in Western Sweden. Additionally we wanted to study incidence in relation to age and gender. Method The VEGA database is an administrative database of all patients managed in hospital care (through direct linkage to the Swedish nationwide patient registry) and/or in primary care facilities (private and public) living in Western Sweden. All patients with a main or contributory diagnosis of HF (I50) >18 years of age between 2008 and 2017 were included in our cohort. HF incidence was calculated based on the entire population of Vastra Gotaland (a region of Western Sweden). Results The adult population in Western Sweden increased by 8% from 2008 (n=1,234,609) to 2017 (n=1,338,906), with 69% <60 years of age and 50% female, both constant over time. In total, 62,229 incident cases of HF were identified during 2008–2017. In 2008 we identified 6464 cases with a mean age of 78.7 (11.5) and 49.8% (n=3222) male patients, while in 2017 5,727 cases were identified with a mean age of 78.3 (11.8) and 52.5% (n=3006) male cases. The yearly incidence rate of HF remained constant over the 10-year period but with large variations by age and gender. A constantly higher incidence of HF was seen for men compared to women in all age categories. Although overall incidence remained constant in the last decade, we did observe decreasing incidence among those >80 years of age with incidence rates dropping from 4.4% to 3.0% between 2008–2017 (80–90 years) and from 7.8 to 5.5% in the same period (>90 years of age). A similar pattern was seen in both men and women in these age groups with incidence decreasing over the last ten years. Conclusion The overall incidence of HF remained unchanged over the last decade. However a declining trend in incidence was observed in the oldest part of the population, who, however, constitutes only approximately 5% of the population. Our findings emphasize the need for implementation of effective preventive strategies for HF. Trends in HF incidence 2007-2018 Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Swedish agreement between the government and the county councils concerning economic support for providing an infrastructure for research and education of doctors (ALF), and the Regional Development Fund, Västra Götaland County, Sweden (FOU-VGR)

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