Heart Failure Epidemiology: European Perspective

Abstract

Heart failure poses an increasing problem for global healthcare systems. The epidemiological data which has been accrued over the last thirty years has predominantly been accumulated from experience within North America and Europe. Initial large cohort, prospective longitudinal studies produced the first publications; however latterly the focus has shifted onto epidemiological data governing hospitalisation and mortality. The emphasis behind this shift has been the resource implications with regards to repetitive, costly and prolonged hospitalisation. The European experience in heart failure, though similar to North America has recently demonstrated differences in hospitalisation which may underlie the differences between healthcare system configuration. Heart failure however remains an increasing global problem and the endpoint of a variety of cardiovascular diseases. Allied with the fact of increasingly elderly populations and prior data demonstrating a steep rise in prevalent cases within more elderly populations, it is likely that the increasing burden of disease will continue to pose challenges for modern healthcare. Despite the predicted increase in the number of patients affected by heart failure, over the last thirty years, a clear management algorithm has evolved for the use of pharmacotherapies (neuro-hormonal antagonists), device based therapies (Implantable Cardioverting Defibrillator (ICD) and Cardiac Resynchronisation Therapy (CRT)) and mechanical therapies including left ventricular assist devices and cardiac transplantation. Though the management of such patients has been clearly delineated in national and international guidelines, the underuse of all available and appropriate therapies remains a significant problem. When comparing various epidemiological studies from different settings and timepoints, it should be remembered that rates of prevalence and incidence may vary depending upon the definition used, methods of accumulating information (with the possibility of bias) and the chosen cut point of defining left ventricular systolic dysfunction (LVSD).

Pulmonary artery pressure‐guided heart failure management: US cost‐effectiveness analyses using the results of the CHAMPION clinical trial

“…Heart failure remains an increasing global problem 22, 48. Coupled with the ageing population and thus increasing numbers of HF patients, the pressure on healthcare payers to reduce hospitalizations will continue unabated.…”

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

“…Znajomość tych czynników oraz ich leczenia jest więc ważna dla optymalnego postępowania u pacjentów z AF [203,204]. [215][216][217]. Są one powiązane podobnymi czynnikami ryzyka i wspólnymi mechanizmami patofizjologicznymi [218].…”

Epidemiology and Prognosis of Heart Failure

“…Even before the millenium a prevalence of 23 million individuals living with heart failure is estimated worldwide [4]. However, epidemiological data predominantly derive from North America and Europe [3] with overall prevalence rates of 1-2% [1]. In particular, the current prevalence is up to 3% [5].…”

“…Also, given that heart failure is a complex syndrome with different phenotypes (see article 1), each with specific clinical characteristics and associated risk factors, prevalence and incidence rates may vary according to the definition of the heart failure subtype [2]. Finally, rates may vary on the basis of the method of collecting data and the criterion for defining left ventricular systolic dysfunction that is applied in the study [3].…”