Trends in death attributed to heart failure over the past two decades in Europe

Abstract

AimsLittle is known regarding temporal trends in mortality attributed to heart failure (HF) from a population perspective. The aim of this study was to assess the mortality related to HF as an underlying cause during the last 20 years in seven European countries. Methods and resultsThe number of deaths with HF as the underlying cause was collected in seven European states: Germany, Greece, England and Wales, Spain, France, Finland, and Sweden from 1987 to 2008. Disease coding for HF was based on the International Classification of Diseases (ICD 9th and 10th versions). We computed age-standardized death rates (SDRs) per 100 000 inhabitants. Mean age at death from HF was also calculated for the same period. In the seven studied countries, the HF SDR decreased continuously from 54.2 (1987) to 32.6 (2008). Despite differences in the early 1990s, SDRs related to HF seemed to converge, in these seven European countries, to 30 deaths per 100 000 population in the near future, for both men and women. During the study period, the mean age at death increased from 80.0 to 82.7 years. Half of the deaths from HF occurred in hospital, without change over time. ConclusionThere has been a 40% reduction of the SDR due to HF in seven European countries during two decades and a concomitant increase in the mean age at death from HF. We hypothesize that these results may be related to a better management of chronic and acute HF patients over the past 20 years.--

Do patients have worse outcomes in heart failure than in cancer? A primary care‐based cohort study with 10‐year follow‐up in Scotland

“…21 Age-standardized death rates from heart failure have been reported to decrease by 40% in seven European countries between 1987 and 2008. 4 An analysis of all patients in Scotland hospitalised with a first episode of heart failure between 1986 and 2003 demonstrated relative declines in short-and mediumterm case-fatality rates of 40-50% in men and 20-25% in women; changes associated with significant increases in ACE inhibitor and beta blocker use over this period. 17 There are limited data regarding longer-term outcomes of incident heart failure in the community.…”

“…2 Advances in pharmacological and intra-cardiac device based therapies have reduced mortality rates in patients with heart failure by as much as 50% over the past decade, but both short and long term mortality rates remain significant. [3][4][5] The adverse outcomes associated with heart failure have drawn comparisons to those of cancer amongst many commentators, including international cardiological societies. 7 Collectively cancer is the second leading cause of morbidity and mortality worldwide, with approximately 14 million new cases and 8.2 million cancer-related deaths in 2012.…”

Peritoneal ultrafiltration in end-stage congestive heart failure

“…Although the last decades brought a considerable improvement in the therapy of patients with CHF, leading to a reduction in their mortality and morbidity, the long-term prognosis remains poor [2].…”

“…A vicious cycle is induced, in which each condition (CHF and CKD) exacerbates and stimulates the progression of the other. Heart failure usually advances more rapidly, and constitutes the leading cause of death before the development of uremia requiring renal replacement therapy [2,3].…”

“…Sodium and water retention, fundamental to this progression, remains also one of the main causes (> 90%) of hospitalizations [2,4]. End-stage CHF is characterized by a significant resistance to pharmacological treatment, especially to diuretics.…”