Clinical epidemiology of heart failure

Mosterd, Arend; Hoes, Arno W.

doi:10.1136/hrt.2003.025270

Cited by 1,583 publications

(1,188 citation statements)

References 26 publications

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“…People with HF often experience a reduction in quality of life, higher mortality rates, and increased risk for other CVD events 31, 32, 33, 34. More than half of the people diagnosed with HF will die within 5 years 32, 33.…”

Section: Discussionmentioning

confidence: 99%

Life's Simple 7 and Incident Heart Failure: The Multi‐Ethnic Study of Atherosclerosis

Ogunmoroti

Oni

Michos

et al. 2017

JAHA

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BackgroundThe American Heart Association introduced the Life's Simple 7 (LS7) metrics to assess and promote cardiovascular health. We sought to examine the association between the LS7 metrics and incident heart failure (HF) in a multiethnic cohort.Methods and ResultsWe analyzed data from 6506 participants of the Multi‐Ethnic Study of Atherosclerosis free of cardiovascular disease at baseline. The LS7 metrics (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol, and blood glucose) were graded on a scale of 0 to 2, with 2 indicating “ideal” status, 1 “intermediate” status, and 0 “poor” status. Points were summed, thus the LS7 score ranged from 0 to 14. Cox proportional hazard ratios and incidence rates of HF per 1000 person‐years were calculated. During a median follow‐up of 12.2 years, 262 (4%) participants developed HF. Incidence of HF decreased as the number of ideal LS7 metrics increased; 5.9 per 1000 person‐years for participants with 0 to 1 ideal metrics and 0.6 per 1000 person‐years for those with 6 to 7 ideal metrics. Compared with inadequate scores (0–8 points), hazard ratios for HF were 0.57 (0.43–0.76) and 0.31 (0.19–0.49) for average (9–10 points) and optimal (11–14 points) scores, respectively. A similar pattern was observed when the results were stratified by 4 racial/ethnic groups: white, Chinese American, black, and Hispanic.ConclusionsA lower risk of HF with more favorable LS7 status regardless of race/ethnicity suggests that efforts to achieve ideal cardiovascular health may reduce the burden of HF, a major source of morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Life's Simple 7 and Incident Heart Failure: The Multi‐Ethnic Study of Atherosclerosis

Ogunmoroti

Oni

Michos

et al. 2017

JAHA

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“…Heart failure (HF) is a relatively common condition, occurring in 1% to 2% of the adult population in Western countries 1, 2. There are a number of factors contributing to ongoing and projected increases in the prevalence of HF, including the aging population demographic and improved patient survival 3, 4.…”

Section: Introductionmentioning

confidence: 99%

Phenotyping of Sleep‐Disordered Breathing in Patients With Chronic Heart Failure With Reduced Ejection Fraction—the SchlaHF Registry

Arzt

Oldenburg

Graml

et al. 2017

JAHA

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BackgroundDifferent sleep‐disordered breathing (SDB) phenotypes, including coexisting obstructive and central sleep apnea (OSA‐CSA), have not yet been characterized in a large sample of patients with heart failure and reduced ejection fraction (HFrEF) receiving guideline‐based therapies. Therefore, the aim of the present study was to determine the proportion of OSA, CSA, and OSA‐CSA, as well as periodic breathing, in HFrEF patients with SDB.Methods and ResultsThe German SchlaHF registry enrolled patients with HFrEF receiving guideline‐based therapies, who underwent portable SDB monitoring. Polysomnography (n=2365) was performed in patients with suspected SDB. Type of SDB (OSA, CSA, or OSA‐CSA), the occurrence of periodic breathing (proportion of Cheyne‐Stokes respiration ≥20%), and blood gases were determined in 1557 HFrEF patients with confirmed SDB. OSA, OSA‐CSA, and CSA were found in 29%, 40%, and 31% of patients, respectively; 41% showed periodic breathing. Characteristics differed significantly among SDB groups and in those with versus without periodic breathing. There was a relationship between greater proportions of CSA and the presence of periodic breathing. Risk factors for having CSA rather than OSA were male sex, older age, presence of atrial fibrillation, lower ejection fraction, and lower awake carbon dioxide pressure (pco 2). Periodic breathing was more likely in men, patients with atrial fibrillation, older patients, and as left ventricular ejection fraction and awake pco 2 decreased, and less likely as body mass index increased and minimum oxygen saturation decreased.ConclusionsSchlaHF data show that there is wide interindividual variability in the SDB phenotype of HFrEF patients, suggesting that individualized management is appropriate.Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01500759.

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“…Prior epidemiological studies have identified a number of important prognostic factors associated with poor long‐term outcomes for patients with ADHF including advanced age, male sex, hyponatremia, lower systolic blood pressure, poorer kidney function, and several comorbid conditions 3, 4, 5, 6, 7, 8, 9, 10, 11, 12. Many of these earlier studies examined the role of various prognostic factors in patients with HF that had not further been stratified according to EF findings, and among those that did,11, 13, 14, 15, 16, 17 none used the 2013 AHA/ACC guidelines recommending specific EF cut points 2.…”

Section: Introductionmentioning

confidence: 99%

Magnitude of and Prognostic Factors Associated With 1‐Year Mortality After Hospital Discharge for Acute Decompensated Heart Failure Based on Ejection Fraction Findings

Coles

Tisminetzky

Yarzebski

et al. 2015

JAHA

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BackgroundLimited data exist about the magnitude of and the factors associated with prognosis within 1 year for patients discharged from the hospital after acute decompensated heart failure. Data are particularly limited from the more generalizable perspective of a population‐based investigation and should be further stratified according to currently recommended ejection fraction (EF) findings.Methods and ResultsThe hospital medical records of residents of the Worcester, Massachusetts, metropolitan area who were discharged after acute decompensated heart failure from all 11 medical centers in central Massachusetts during 1995, 2000, 2002, 2004, and 2006 were reviewed. The average age of the 4025 study patients was 75 years, 93% were white, and 44% were men. Of these, 35% (n=1414) had reduced EF (≤40%), 13% (n=521) had borderline preserved EF (41–49%), and 52% (n=2090) had preserved EF (≥50%); at 1 year after discharge, death rates were 34%, 30%, and 29%, respectively (P=0.03). Older age, a history of chronic obstructive pulmonary disease, systolic blood pressure findings <150 mm Hg on admission, and hyponatremia were important predictors of 1‐year mortality for all study patients, whereas several comorbidities and physiological factors were differentially associated with 1‐year death rates in patients with reduced, borderline preserved, and preserved EF.ConclusionsThis population‐based study highlights the need for further contemporary research into the characteristics, treatment practices, natural history, and long‐term outcomes of patients with acute decompensated heart failure and varying EF findings and reinforces ongoing discussions about whether different treatment guidelines may be needed for these patients to design more personalized treatment plans.

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Clinical epidemiology of heart failure

Cited by 1,583 publications

References 26 publications

Life's Simple 7 and Incident Heart Failure: The Multi‐Ethnic Study of Atherosclerosis

Life's Simple 7 and Incident Heart Failure: The Multi‐Ethnic Study of Atherosclerosis

Phenotyping of Sleep‐Disordered Breathing in Patients With Chronic Heart Failure With Reduced Ejection Fraction—the SchlaHF Registry

Magnitude of and Prognostic Factors Associated With 1‐Year Mortality After Hospital Discharge for Acute Decompensated Heart Failure Based on Ejection Fraction Findings

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