epidemiology

Last edited 10/2018 and last reviewed 02/2022

• around 920,000 people in the UK today have been diagnosed with heart failure (1)
  • the incidence and prevalence of heart failure increase steeply with age, and the average age at diagnosis is 77
  • overall prevalence of heart failure is rising because of population ageing and increasing rates of obesity
    
    
• men have a higher risk of getting HF than women in all age groups but there are more women than men with HF due to population demographics (1,2)

• most common cause of CHF is coronary heart disease (CHD), which accounts for around two-thirds of cases, and there is usually a history of myocardial infarction (MI)
• remainder of cases have a non-ischaemic cause, for example hypertension, valvular disease, and arrhythmias such as atrial fibrillation. Advancing age, smoking, hyperlipidaemia and diabetes mellitus are among the associated risk factors

• mortality rates as high as 50% within four years have been suggested
  • about half of deaths from heart failure are sudden deaths

• estimated that heart failure accounts for around 2% of all inpatient bed-days and 5% of all medical emergency admissions

• prevalence of definite or probable heart failure of 3.1%, based on echocardiographic assessment
  • prevalence rises sharply with age from about 1 in 35 people aged 65-74 years, to about 1 in 15 of those aged 75-84 years, and to just over 1 in 7 in those aged 85 years and above
• prevalence of CHF is increasing owing to higher survival rates from MI and the increasing elderly population
• in recent times the prevalence of HF with preserved left ventricular ejection fraction has increased which seems to reflect the rise in prevalence of hypertension, diabetes, atrial fibrillation and obesity (1,2)  

• annually a GP will look after 30 people with HF out of which a new diagnosis of HF will be suspected in around 10 patients (2).

Notes:

• infections, anaemia, alcohol abuse, side effects of medicines such as non-steroidal antiinflammatory drugs (NSAIDs), and noncompliance with prescribed drugs can exacerbate heart failure

Reference:

• (1) NICE 2010. Chronic heart failure. National clinical guideline for diagnosis and management in primary and secondary care  
• (2) NICE (September 2018).Chronic heart failure in adults: diagnosis and management
• (3) MeReC Bulletin 2008; 18 (3):1-9