Heart Failure Cases Soar Globally
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The number of patients with heart failure worldwide nearly doubled from 33.5 million in 1990 to 64.3 million in 2017, according to findings.

The analysis used data from the Global Burden of Disease Study to examine the burden and causes of heart failure from 1990 to 2017 in 195 countries and territories. The age-standardized prevalence rate showed a slow downward trend, suggesting that population ageing and growth are responsible for most of the increase in prevalence.

The study revealed major differences between regions of the world. The researchers used the socio-demographic index (SDI) to categorize the 195 countries and territories into five groups according to development status: low, low-middle, middle, high-middle, and high SDI. Between 1990 and 2017, the age-standardized prevalence rate of heart failure decreased by 20.3% in high SDI countries but increased in the low, low-middle, and middle SDI countries.

The researchers said the rising prevalence rate of heart failure in the low, low-middle, and middle SDI countries “is driven by a surge of risk factors such as hypertension, diabetes mellitus, obesity, smoking, and other unhealthy lifestyles”.

Nearly half of the global increase in the number of heart failure patients during 1990 to 2017 was in China (29.9%) and India (16.6%). The researchers said: “An interplay of factors such as population growth, unhealthy behaviors including smoking, and air pollution are likely explanations.”

The study found that years lived with disability due to heart failure have doubled worldwide since 1900, while the age-standardized rate remained stable.

There were stark differences in disability according to SDI category. A large decline in the age-standardized rate of years lived with disability was observed in high SDI countries – which the researchers attributed to better prevention and treatment of heart failure. After an initial rise in high-middle and middle SDI countries, rates began to decline in 2010. But the rate continually deteriorated in low and low-middle SDI countries.

Ischemic heart disease, hypertensive heart disease, and COPD were the top three causes of heart failure, accounting for nearly three-quarters of the age-standardized prevalence rates.

The researchers concluded, “Heart failure is a global public health concern. Public health workers and policymakers can use the data provided in this study to design interventions to prevent and manage heart failure in their countries. In addition, educational campaigns are needed to increase awareness about the importance of adopting healthy lifestyles.”