Prevalence of Symptomatic Heart Failure with Reduced and with Normal Ejection Fraction in an Elderly General Population–The CARLA Study

Chronic heart failure (CHF) is one of the most important public health concerns in the industrialized world having increasing incidence and prevalence. Although there are several studies describing the prevalence of heart failure with reduced ejection fraction (HFREF) and heart failure with normal e...

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Published in:PloS one Vol. 8; no. 3; p. e59225
Main Authors: Tiller, Daniel, Russ, Martin, Greiser, Karin Halina, Nuding, Sebastian, Ebelt, Henning, Kluttig, Alexander, Kors, Jan A., Thiery, Joachim, Bruegel, Mathias, Haerting, Johannes, Werdan, Karl
Format: Journal Article
Language:English
Published: United States Public Library of Science 15.03.2013
Public Library of Science (PLoS)
Subjects:
Age
Age Factors
Aged
Aged, 80 and over
Analysis
Cardiology
Cardiovascular disease
Cardiovascular diseases
Chronic Disease
Chronic obstructive pulmonary disease
Diabetes
Echocardiography
Epidemiology
Female
Geriatrics
Germany - epidemiology
Health risk assessment
Health risks
Heart
Heart attack
Heart diseases
Heart failure
Heart Failure - blood
Heart Failure - diagnostic imaging
Heart Failure - epidemiology
Heart Failure - physiopathology
Humans
Hypertension
Informatics
Laboratories
Male
Medicine
Men
Middle Aged
Myocardial infarction
Natriuretic Peptide, Brain - blood
Older people
Peptide Fragments - blood
Peptides
Population
Population studies
Prevalence
Prognosis
Public health
Risk analysis
Risk Factors
Stroke Volume
Studies
Superhigh frequencies
Ultrasonography
Germany
ISSN:1932-6203, 1932-6203
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Summary:Chronic heart failure (CHF) is one of the most important public health concerns in the industrialized world having increasing incidence and prevalence. Although there are several studies describing the prevalence of heart failure with reduced ejection fraction (HFREF) and heart failure with normal ejection fraction (HFNEF) in selected populations, there are few data regarding the prevalence and the determinants of symptomatic heart failure in the general population. Cross-sectional data of a population-based German sample (1,779 subjects aged 45-83 years) were analyzed to determine the prevalence and determinants of chronic SHF and HFNEF defined according to the European Society of Cardiology using symptoms, echocardiography and serum NT-proBNP. Prevalence was age-standardized to the German population as of December 31st, 2005. The overall age-standardized prevalence of symptomatic CHF was 7.7% (95%CI 6.0-9.8) for men and 9.0% (95%CI 7.0-11.5) for women. The prevalence of CHF strongly increased with age from 3.0% among 45-54- year-old subjects to 22.0% among 75-83- year-old subjects. Symptomatic HFREF could be shown in 48% (n = 78), symptomatic HFNEF in 52% (n = 85) of subjects with CHF. The age-standardized prevalence of HFREF was 3.8 % (95%CI 2.4-5.8) for women and 4.6 % (95%CI 3.6-6.3) for men. The age-standardized prevalence of HFNEF for women and men was 5.1 % (95%CI 3.8-7.0) and 3.0 % (95%CI 2.1-4.5), respectively. Persons with CHF were more likely to have hypertension (PR = 3.4; 95%CI 1.6-7.3) or to have had a previous myocardial infarction (PR = 2.5, 95%CI 1.8-3.5). The prevalence of symptomatic CHF appears high in this population compared with other studies. While more women were affected by HFNEF than men, more male subjects suffered from HFREF. The high prevalence of symptomatic CHF seems likely to be mainly due to the high prevalence of cardiovascular risk factors in this population.
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Competing Interests: The authors have declared that no competing interests exist.
Helped draft the manuscript: MR SN HE AK JH KHG KW. Read and approved the final manuscript: DT MR KHG SN HE AK JK JT MB JH KW. Conceived and designed the experiments: JH KHG KW. Performed the experiments: MR SN HE. Analyzed the data: DT AK. Contributed reagents/materials/analysis tools: JT MB. Wrote the paper: DT.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0059225