Epidemiological Aspects (Prevalence and Risk of Heart Failure Related to Blood Pressure)
Heart failure (HF) is a common, highly morbid, and costly clinical syndrome with a growing impact on global public health. Hypertension is the most prevalent risk factor for HF and carries the highest population attributable risk among all risk factors fo
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Epidemiological Aspects (Prevalence and Risk of Heart Failure Related to Blood Pressure) Peter Wohlfahrt and Renata Cífková
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Prevalence and Incidence of Heart Failure
1.1.1 Heart Failure Definition and Classification According to the European Society of Cardiology guidelines, HF is defined as a clinical syndrome characterized by typical symptoms (e.g., breathlessness, ankle swelling, and fatigue) that may be accompanied by signs (e.g., elevated jugular venous pressure, pulmonary crackles, and peripheral edema) caused by a structural and/or functional cardiac abnormality resulting in a reduced cardiac output and/or elevated intracardiac pressures at rest or during stress [1]. Heart failure can present with preserved ejection fraction (HFpEF), midrange ejection fraction (HFmrEF), or reduced ejection fraction (HFrEF). These three entities differ in their epidemiological profiles, presentation, and mechanisms. Compared with HFrEF, patients with HFpEF are older and more commonly have hypertension and atrial fibrillation, while a history of myocardial infarction is less common. In several studies, HFpEF was more common in females than in males. This may be partially explained by sex distribution in the highest age groups (60% of the US population aged ≥75 years are women). A recent analysis has shown that among individuals of similar age and similar prevalence of other HF risk factors, women are not at higher risk of HFpEF
P. Wohlfahrt (*) Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Prague, Czech Republic R. Cífková Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Prague, Czech Republic Department of Medicine II, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic e-mail: [email protected] © Springer Nature Switzerland AG 2019 M. Dorobantu et al. (eds.), Hypertension and Heart Failure, Updates in Hypertension and Cardiovascular Protection, https://doi.org/10.1007/978-3-319-93320-7_1
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than men but are at a lower risk for HFrEF [2]. Heart failure with midrange ejection fraction is an intermediate phenotype, with the prevalence of ischemic heart disease (IHD) similar to that of HFrEF, while other demographic characteristics, symptom profile, comorbidities, laboratory values, and short-term outcomes are closer to those with HFpEF [3].
1.1.2 Heart Failure Prevalence Heart failure remains a rising global epidemic with an estimated current prevalence of 38 million worldwide. The prevalence of HF in developed countries is approximately 1–3% of the adult population, rising to ≥10% among people over 70 years of age (Fig. 1.1). In individuals aged 55 years, 1 in 3 will develop HF during their remaining life span [4]. In the community, approximately one half of HF patients have preserved ejection fraction, while isolated diastolic dysfunction is present in 44% of HF cases [5]. The incidence and prevalence of HFpEF i
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