Heart Failure Rates Reaching Epidemic Levels for
Senior Citizens in U.S.
Those over age 65 hospitalized for heart failure
increased by 131%t between 1980 and 2006
Nov.
10, 2008 - Heart failure is reaching epidemic levels among seniors in
the United States, according to research presented at the American Heart
Associations Scientific Sessions 2008. Among the three major forms of
cardiovascular disease (coronary heart disease and stroke being the
other two), only heart failure has shown a significant increase in
hospitalization rates.
Thiazolidinediones medications (including rosiglitazone
(Avandia)
produced a significantly increased risk of heart attack, congestive
heart failure and death
Both the number of patients hospitalized with a
primary diagnosis of heart failure and age-adjusted hospitalization
rates for heart failure have increased dramatically over the past 27
years, said Longjian Liu, M.D., Ph.D., M.Sc., author of the study,
associate professor of Epidemiology and Biostatistics of the Drexel
University School of Public Health in Philadelphia, Pa.
The prevention and treatment of heart failure has
become an urgent public health need with national implications.
A chronic disease, heart failure occurs when any
part of the heart muscle weakens and the heart cant supply the bodys
cells with enough oxygen- and nutrient-rich blood. Everyday activities
can become very difficult due to fatigue and shortness of breath. An
estimated 5.3 million Americans live with heart failure, and 660,000 new
cases are diagnosed each year, according to the American Heart
Association.
Lius study is the first to examine the diseases
hospitalization rates over the last 27 years and is the initial portion
of a serial report on heart failure epidemiology in the United States.
About Heart Diseases
Also called: Cardiac disease
If you're like most
people, you think that heart disease is a problem for other
folks. But heart disease is the number one killer in the U.S. It
is also a major cause of disability.
There are many
different forms of heart disease.
The most common
cause of heart disease is narrowing or blockage of the coronary
arteries, the blood vessels that supply blood to the heart
itself. This is called
coronary
artery disease and happens slowly over time. It's the
major reason people have
heart
attacks.
Other kinds of heart problems may happen
to the
valves
in the heart, or the heart may not pump well and cause
heart
failure. Some people are
born
with heart disease.
You can help reduce your risk of heart
disease by taking steps to control factors that put you at
greater risk:
● Control your
blood
pressure
● Lower your
cholesterol
● Don't smoke
● Get enough exercise
Heart failure is a condition in which the
heart can't pump enough blood throughout the body. Heart failure
does not mean that your heart has stopped or is about to stop
working. It means that your heart is not able to pump blood the
way it should.
The weakening of the heart's pumping
ability causes
● Blood and fluid to back up into the lungs
● The buildup of fluid in the feet, ankles and legs - called
edema
● Tiredness and shortness of breath
Each year over a million people in the
U.S. have a heart attack. About half of them die. Many people
have permanent heart damage or die because they don't get help
immediately. It's important to know the symptoms of a heart
attack and call 9-1-1 if someone is having them.
Those symptoms include
● Chest discomfort - pressure, squeezing, or pain
● Shortness of breath
● Discomfort in the upper body - arms, shoulder, neck, back
● Nausea, vomiting, dizziness, lightheadedness, sweating
These symptoms can sometimes be different
in
women.
What exactly is a heart attack? Most
heart attacks happen when a clot in the coronary artery blocks
the supply of blood and oxygen to the heart. Often this leads to
an irregular heartbeat called an
arrhythmia - that causes a severe decrease in the pumping
function of the heart. A blockage that is not treated within a
few hours causes the affected heart muscle to die.
This study used data from more than 2.2 million
patients (age 65 or older) in the National Hospital Discharge Surveys
between 1980 and 2006. This national representative survey provides
annual estimates of hospital discharges in the United States.
In the study, heart failure was defined as patients
with a primary diagnosis of heart failure at hospital discharge. This
study broke the data down into three age groups: 6574, 7584 and 85 or
older by gender, and then estimated statistically the hospitalization
rates with census population data in terms of gender and time periods.
He found the following:
The estimated number of patients age 65 and older
who were hospitalized for heart failure increased from 348,866 in 1980
to 807,082 in 2006 a 131 percent increase.
For men, rates rose from 16.57 hospitalizations
per 1,000 members of the population in 1980 to 22.87 in 2006.
For women, rates rose from 13.95 hospitalizations
per 1,000 members of the population to 19.58 in 2006.
Women had a significantly higher annual
percentage increase rate than men (55 percent vs. 20 percent).
From 20022006, the relative risk of being
hospitalized due to heart failure was 1.37 times higher than it had been
from 198084.
Patients ages 7584 had twice the risk of being
hospitalized for heart failure than those 6574; those age 85 or older
had four times more risk of hospitalization for heart failure than those
ages 6574.
The study also showed that, among the three major
forms of cardiovascular disease, coronary heart disease and stroke have
shown decreases in hospitalization rates since the mid-1980s. However,
heart failure has shown a continuously significant increase in
hospitalization rates since 1980.
Directly and indirectly, heart failure is expected
to cost $34.8 billion in the United States this year, according to
American Heart Association data. The peak of the crisis is still to
come, Liu said.
Over the next decades, the number of U.S. adults
age 65 and older will double to a projected 70 million, and more than
one in five will be 65 or older by the year 2030, he said.
Because heart failure disproportionately affects
the elderly, there is no doubt that the burden of heart failure will
increase unless innovative strategies are implemented. The key is to
prevent risk factors for the disease.
These risk factors include high blood pressure,
coronary heart disease, chronic obstructive pulmonary disease, valvular
heart disease, diabetes, stroke, obesity and lifestyle risk factors such
as smoking, physical inactivity and fatty food intake.
Efforts also should be made to prevent chronic
kidney disease and pneumonia as they contribute to heart failure as
well, Liu said.
Liu listed no specific funding support for the
study. Author disclosures are available on the abstract.
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