Focus on: Epidemiology of Cardiovascular Disease in Spain Over the Past 20 Years (III)Epidemiology of Heart Failure in Spain Over the Last 20 YearsEpidemiología de la insuficiencia cardiaca en España en los últimos 20 años
Section snippets
INTRODUCTION
Heart failure (HF) is a major concern in public health.1 In the developed world, this disease affects approximately 2% of the adult population, a prevalence that increases exponentially with age. The prevalence is lower than 1% in the population aged less than 50 years but doubles with each decade, and exceeds 8% in persons aged more than 75 years.2 In Spain, the large number of patients with HF is essentially due to progressive population aging. In the interval between the 1991 census and 1
INCIDENCE AND PREVALENCE OF HEART FAILURE IN SPAIN
Incidence is defined as the number of new cases of a disease appearing in a given population over a specific period. In Spain, there is only one study of the incidence of HF.11 This study was performed the population of Puerto Real, a provincial town in the southwest of the country, and analyzed the population older than 14 years (267 231 inhabitants) registered with the Spanish National Health Service between 2000 and 2007. Diagnosis of HF was based on the Framingham clinical criteria. The
DEMOGRAPHIC AND CLINICAL CHARACTERISTICS OF PATIENTS WITH HEART FAILURE IN SPAIN
Despite the discrepancies in the reported incidence and prevalence of HF, this disease clearly has a substantial impact on health care in Spain. For this reason, research into the causes of HF and its risk factors, clinical profile, and associated comorbidities, etc., are important to plan appropriate prevention and treatment strategies. Because of the environmental, dietary, and cultural peculiarities of a Mediterranean country such as Spain, the risk factors and clinical course of patients
HOSPITAL ADMISSIONS FOR HEART FAILURE
The natural history of HF is punctuated by decompensations that usually require hospitalization and tend to follow a bimodal pattern, with more frequent peaks after diagnosis (30% of readmissions in HF) and in the final stage of the disease (50% of readmissions).32 In Spain, as in other industrialized countries, HF is the leading cause of hospitalization in persons older than 65 years.7 One direct consequence is the financial burden on the Spanish National Health Service. In 1997, Antoñanzas et
HEART FAILURE AS A CAUSE OF DEATH
In the European Union, cardiovascular diseases are the principle cause of death,49 whereas in Spain they come second to cancer.50 In Spain, HF is the fourth cause of cardiovascular death (after ischemic heart disease, cerebrovascular disease, and other heart diseases) and is responsible for 10% of deaths from a circulatory cause in men and 16% in women. Data from Spain's National Institute of Statistics50 indicate that HF caused an absolute 3% of deaths in men and 10% in women in 2010. Overall,
CONCLUSIONS
Historically, in Spain, there has been a lack of reliable nationwide, population-based studies to allow accurate measurement of the impact of HF. While the prevalence of HF in other European countries and the United States is approximately 2%, Spanish studies report figures of 5% or higher. This difference is unlikely to reflect reality and is more likely due to methodological limitations of studies in Spain.
The clinical characteristics of patients with HF form two typical patterns: one with
CONFLICTS OF INTEREST
None declared.
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