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Increasing risk for heart failure in aging population


Researchers from the University of Massachusetts Medical School looked at the incidence of heart failure in residents of the Worcester, Massachusetts metropolitan area.

The results of this study suggest that heart failure is an important clinical syndrome affecting residents of this large northeast community.
Several groups at high risk for developing or dying from heart failure can be identified and targeted for preventive efforts as well as for the receipt of effective treatment modalities.

Information was collected for 2548 adult men and women of all ages hospitalized for possible heart failure ( HF ) at all 11 greater Worcester medical centers during 2000.
Demographic, medical history, laboratory and physiologic measures, and clinical characteristics of the study sample were determined through the review of information contained in hospital medical records.

The incidence rate ( per 100,000 ) of HF was 213. Occurrence of acute heart failure increased markedly with advancing age and women were at greater risk for HF than men ( incidence rates [ per 100 000 ] = 246 and 189, respectively ).

In the total study sample, 5.1% of patients with decompensated heart failure died during the acute hospitalization.
Among patients with a first documented episode of HF, 5.5% of patients died.
Patients dying during the acute hospitalization were more likely to be older, of desirable body weight, and have a history of anemia or stroke.
Patients with higher concentrations of blood urea nitrogen, serum creatinine, and admission heart rates were more likely to die than respective comparison groups.

On the other hand, patients with lower serum sodium concentrations and lower systolic and diastolic blood pressure values were at greater risk for dying during hospitalization than patients with higher levels of these clinical variables.

Senior investigator Robert J. Goldberg states, “ Our findings … argue for the importance of population-based registries for the more systematic study of this clinical syndrome. These community-wide surveillance projects need to be developed and maintained for long periods of time to provide timely and ongoing insights to the effective primary and secondary prevention of this serious clinical problem.”

He continues, “ The results of the present investigation confirm that acute heart failure represents a considerable burden to the health of the community, particularly in older individuals. Given the aging of the U.S. population, and declining national death rates due to cardiovascular disease placing these individuals at increased risk for heart failure during their latter years of life, increasing trends in the magnitude and morbidity of heart failure are likely to continue for the foreseeable future. These trends, as well as changes in the management of patients with acute and chronic manifestations of heart failure over time, warrant further monitoring, particularly in representative U.S. communities.”

Source: The American Journal of Medicine, 2005


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