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Heart Failure Hospitalizations Up Sharply
Date:11/9/2008

Epidemic linked to hypertension, obesity, diabetes, study shows

SUNDAY, Nov. 9 (HealthDay News) -- Hospitalization rates for heart failure among older Americans have increased dramatically in the past three decades, an epidemic that represents a mounting burden on the health-care system, a new study has found.

In 2006, an estimated 807,082 men and women over 65 were hospitalized for heart failure, up from 348,866 in 1980 -- a 131 percent increase.

And the increase in hospitalization rates has been more dramatic among women than men, according to the Drexel University study, to be presented Sunday at the American Heart Association's annual scientific sessions in New Orleans.

"You could probably talk to any cardiologist, no matter what practice setting they're in, and even primary-care physicians who do hospital work, and you're going to find this is an extremely common scenario," said Dr. John Erwin III, an associate professor of internal medicine at the Texas A&M Health Science Center College of Medicine and a senior staff cardiologist with Scott & White Hospital in Temple.

"By far, heart failure is the leading diagnosis code when patients are admitted to the hospital, especially in those over 65," he said.

"Clearly we know that patients who are older in age require longer hospital stays and usually have other co-morbidities [illnesses] such as renal failure or anemia," Erwin added. "This is going to put a huge burden on the health-care system. It already is."

Heart failure occurs when the heart muscle can no long pump enough blood to the different parts of the body. More than 5 million Americans are thought to live with heart failure, with another 660,000 cases diagnosed each year.

Medical advances have, ironically, led to more heart failure, Erwin said. "Patients that used to come into hospitals with heart attacks and died in years past are living, but are living with heart failure," he said. "While we're successful now with heart attacks more frequently, this is part of what's left over."

The heart failure epidemic is mirrored by a number of other epidemics, such as high blood pressure, obesity and diabetes, all of which are also risk factors for heart failure, the study authors said.

The study, the first to look at heart failure hospitalization rates over the past three decades, examined hospital discharge data on more than 2.2 million people aged 65 and older from 1980 through 2006.

The researchers, from Drexel's School of Public Health in Philadelphia, found that:

  • The hospitalization rate for heart failure jumped 131 percent between 1980 and 2006.
  • The number of women hospitalized for heart failure increased 55 percent annually, compared to 20 percent annually for men.
  • The relative risk of being hospitalized for heart failure was 37 percent higher for those living from 2002 to 2006 than for those living from 1980 to 1984.
  • People aged 85 and older had four times the risk of being hospitalized with heart failure, compared to those aged 65 to 74. People aged 75 to 84 had double the risk of hospitalization compared to those a decade younger.
  • Hospitalization rates for coronary heart disease and stroke have decreased since the mid-1980s; heart failure is the only one of three major forms of cardiovascular disease to show an increase.

The trend is likely to get worse as the U.S. population continues to age, the study authors said.

But there are some efforts under way to lessen the current and future burden, Erwin said.

"Several organizations are working hard to develop disease management strategies, very basic things we can do for heart failure that, if we adhere to them, the likelihood that a patient will be readmitted due to exacerbation is very much lower," he said. "Those are going to be key, and national efforts to get diabetes and blood pressure and obesity under control are going to be key."

More information

The American Heart Association has more on heart failure.



SOURCES: John Erwin III, M.D., associate professor, internal medicine, Texas A&M Health Science Center College of Medicine, and senior staff cardiologist, Scott & White Hospital, Temple; Nov. 9, 2008, presentation, American Heart Association's annual scientific sessions, New Orleans


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