HF prevalence in adults may be as high as 2%
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The prevalence of HF in the adult population is 1% to 2%, according to a meta-analysis of populations from 11 countries published in Heart.
“Given that we know that the incidence of heart failure increases with population age, a modern, broad view of what the heart failure population looks like, involving risks and costs, is important for all forms of care planning,” Anna Norhammar, MD, adjunct professor at the cardiology unit, department of medicine (Solna), Karolinska Institute, Solna, Sweden, said in a press release.
Data were derived from Norhammar A, et al. Heart. 2023;doi:10.1136/heartjnl-2022-321702.
Norhammar and colleagues conducted the CaReMe study of 629,624 patients with diagnosed HF included in registries from 11 countries — nine European nations, Canada and Israel — between 2018 and 2020. The analysis included a broad definition of HF, defined as any HF diagnosis, and a strict definition of HF, defined as a history of HF hospitalization. The researchers reported event rates per 100 patient-years and calculated cumulative hospital care costs per patient for 5 years.
HF prevalence
The researchers determined the prevalence of HF in the background population of more than 32 million adults was 2.01% (95% CI, 1.65-2.36) using the broad definition and 1.05% (95% CI, 0.85-1.25) using the strict definition.
In patients meeting the broad definition of HF, the mean age was 75.2 years, 48.8% had ischemic heart disease and 34.5% had diabetes, the researchers wrote.
In 169,518 patients with recorded estimated glomerular filtration rate (eGFR), 49% had chronic kidney disease (CKD) stages III to V (eGFR < 60 mL/min/1.73 m2), according to the researchers.
“Half of the heart failure patients had ischemic heart disease, half had signs of kidney failure and a third had diabetes,” Norhammar said in the release. “One likely reason for the escalation in comorbidity in such patients is that we live longer nowadays with several concurrent conditions. This complicates heart failure care even more, as there are many contributory factors to take account of.”
Among the 51,442 patients with recorded left ventricular ejection fraction, 39.1% had reduced EF (95% CI, 30.3-47.8), 18.8% had mildly reduced EF (95% CI, 13.5-24) and 42.1% had preserved EF (95% CI, 31.5-52.8), according to the researchers.
The rate of events per 100 patient-years was highest for cardiorenal disease (defined as HF or CKD) at 19.3 (95% CI, 11.3-27.2) and all-cause mortality at 13.1 (95% CI, 11.1-15.1), Norhammar and colleagues wrote.
Among the 74% of patients for whom hospital health care costs were available, the highest costs were for HF and CKD, with costs for atherosclerotic CVD being lower, according to the researchers.
“In Europe, 1% to 2% of the total health care budget goes toward heart failure care, a cost that is expected to increase,” Norhammar said in the release. “The health care costs are mainly related to a deterioration in heart and kidney failure that requires hospitalization, and to a lesser extent to traditional cardiovascular diseases such as heart attack and stroke. So our data make it clear that intervention to prevent further heart and kidney failure is needed.”
‘We have high hopes’
Norhammar said in the release that SGLT2 inhibitors were not in wide use as treatments for HF, especially HFpEF, during the study period.
“Now that the evidence is here, it’ll be interesting to see if the situation can be improved, as we have high hopes it will,” she said.
Reference:
- Karolinska Institute. https://news.ki.se/heart-failure-places-a-great-strain-on-healthcare. Published Feb. 13, 2023. Accessed Feb. 14, 2023.
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