Heart failure across Asia: Same healthcare burden but differences in organization of care

Abstract

A gap in the knowledge on the status of heart failure (HF) in Asia versus other regions led to the creation of a working group of Asian experts from 9 countries or regions (Hong Kong, Indonesia, Malaysia, Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam). Each expert sought the best available data from local publications, registries, or clinical practice. The prevalence of HF in Asia was generally similar to global values (1% to 3%), but with some outliers. There were substantial variations in healthcare spending, and the average cost of HF hospitalization varied from 813 US$ in Indonesia to nearly 9000 US$ in South Korea. Comorbidities were frequent, particularly hypertension, diabetes mellitus, and dyslipidemia. Modifiable risk factors such as smoking were alarmingly common in some countries. Asian HF patients spent between 5 and 12.5days in hospital, and 3% to 15% were readmitted for HF by 30days. The pharmacological treatment of Asian patients generally followed international guidelines, including renin-angiotensin-aldosterone system inhibitors (61% to 90%), diuretics (76% to 99%), beta-blockers (32% to 78%), and digoxin (19% to 53%), with some room for improvement in terms of life-saving therapies. Our review supports implementation of a more comprehensive and organized approach to HF care in Asia.

Epidemiologic burden of hospitalisation for congestive heart failure among adults aged ≥19 years in the Philippines

“…This was not observed in the current study based on the PhilHealth database, where atherosclerotic heart disease was reported in only 0.3% of cases. Instead, the current study showed hypertension as a common aetiology of CHF, similar to the findings of a recent paper by Reyes et al 20 on heart failure in Asia, where the prevalence of hypertension was higher compared to CAD. Since most claims with encoded aetiology did not have any data on whether they had systolic and/or diastolic heart failure, similarities or differences to international patterns regarding systolic or diastolic heart failure could not be inferred.…”

An overview of hypertension and cardiac involvement in Asia: Focus on heart failure

“…Most of the published studies reported a prevalence between 1% and 2% of the adult population, and the prevalence of HF in Asia was generally similar to the global values (1% to 3%) . Values >5% were reported from Indonesia and Taiwan . The Asian‐HF patients appeared to be younger than the European and American HF patients.…”

“…The number of HF patients has been increasing rapidly and are estimated to be 26 million worldwide . Most of the published studies reported a prevalence between 1% and 2% of the adult population, and the prevalence of HF in Asia was generally similar to the global values (1% to 3%) . Values >5% were reported from Indonesia and Taiwan .…”

“…Life expectancy continues to rise globally, resulting in an increase in the elderly population . The increase in the prevalence of hypertension and HF in Asian countries is related to the changes in lifestyle . Hypertension is also the leading preventable cause of premature death worldwide.…”

Association of left ventricular ejection fraction with contrast-induced nephropathy and mortality following coronary angiography or intervention in patients with heart failure

“…Heart failure (HF) is a common and deteriorating condition, which has a high prevalence of ischemic origin 5. With the advancement of HF or cardiac impairment, adverse hemodynamic state results in inadequate renal perfusion and accelerates the renal impairment after contrast medium (CM) administration 6,7.…”