Up to 2% of adults in Europe, North America, and Israel are likely to have heart failure, according to new estimates published today.
A Swedish study examined the digital health records for 11 countries and said urgent action is needed to tackle the high prevalence of the condition and its associated health risks, which include coronary artery disease and chronic kidney failure.
The disease is also expensive, with Europe and the US each allocating between 1% and 2% of their annual healthcare budgets towards treating it, the researchers say.
The authors, from the Karolinska Institute, designed the CardioRenal and Metabolic disease (CaReMe) heart failure study to estimate the prevalence, key unfavourable outcomes, and costs of the condition in Sweden, Norway, UK, Belgium, Germany, Switzerland, Italy, Spain, Portugal, Israel and Canada.
The team summarised and pooled the data from the individual healthcare systems, finding more than 600,000 people with diagnosed heart failure between 2018 and 2020.
Heart failure was broadly defined as any registered heart failure diagnosis, and strictly defined as requiring admission to hospital for the condition.
The average age of patients, using the broad definition, was 75 and 45% were women. Out of the total cohort, 42% had preserved left ventricular ejection fraction, 49% had ischaemic heart disease, 44% had atrial fibrillation, and 34.5% had diabetes.
Among the 170,000 people with heart failure whose kidney function was measured, 49% had moderate to severe chronic kidney disease.
Based on the data, which is published in *Heart*, the researchers estimate the prevalence of heart failure among adults was 2% when applying the broad definition and 1% when applying the strict definition, across all 11 countries and more than 32 million people.
The highest prevalence in the broad definition category was in Portugal at just under 3%, while it was lowest in the UK at almost 1.5%.
Risks of annual hospital admission were highest for those with heart failure and chronic kidney disease (19%) and lower for those with other cardiovascular disease, such as heart attack (3%), stroke (2%), and peripheral artery disease (1%). The annual death rate was 13%.
The authors say their figures indicate that preventive treatment should primarily focus on reducing the worsening of heart failure and kidney function.
The costs of hospital care, available for six countries and 462,825 patients, were highest for those with both heart and kidney disease, and higher than those stemming from coronary artery disease and stroke.
Although this was an observational study, with several limitations, the authors said their findings indicate the need for urgent action.
Researcher Professor Anna Norhammar said: “Given that we know that the incidence of heart failure increases with population age, a modern, broad view of what the heart failure population looks like, involving risks and costs, is important for all forms of care planning.”
She added: “The healthcare costs are mainly related to a deterioration in heart and kidney failure that requires hospitalisation, and to a lesser extent to traditional cardiovascular diseases such as heart attack and stroke. So our data make it clear that intervention to prevent further heart and kidney failure is needed.”
Norhammar A, Bodegard J, Vanderheyden M et al. Prevalence, outcomes and costs of a contemporary, multinational population with heart failure. *Heart* 14 February 2023; doi 10.1136/heartjnl-2022-321702
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