In a assessment article printed within the journal Nature Evaluations Cardiology, the authors present an in depth overview of the worldwide burden of coronary heart failure, together with the incidence and prevalence of coronary heart failure, illness etiology, threat components, and illness outcomes throughout geographical areas and populations.
Evaluation Article: International epidemiology of coronary heart failure. Picture Credit score: Vector_Leart / Shutterstock
Background
Coronary heart failure is a multifactorial scientific syndrome attributable to structural and useful cardiac abnormalities. The important thing signs embody shortness of breath, ankle swelling, fatigue, and scientific signs, equivalent to elevated jugular venous stress, pulmonary crackles, and peripheral edema.
Coronary heart failure could be of three varieties relying on the left ventricular ejection fraction, i.e., coronary heart failure with preserved ejection fraction, coronary heart failure with mildly diminished ejection fraction, and coronary heart failure with diminished ejection fraction.
Non-modifiable threat components of coronary heart failure embody age, gender, and genetic variants. Medically modifiable threat components embody hypertension, diabetes, weight problems, hyperlipidemia, atrial fibrillation, sleep apnea, poor renal operate, pregnancy-related hypertension, continual kidney illness, and continual obstructive pulmonary illness.
Way of life-related threat components of coronary heart failure embody smoking and alcohol consuming habits, unhealthy eating regimen, lack of bodily exercise, stress, and socioeconomic deprivation.
Prevalence of coronary heart failure in North America and Europe
The prevalence of coronary heart failure is progressively growing worldwide, which could be attributed to growing older populations, a rise in threat components, higher therapy outcomes, and improved survival. A 29% improve within the world prevalence of coronary heart failure occurred between 2010 and 2019.
An estimated world prevalence of coronary heart failure was 56.2 million people in 2019, with the very best prevalence noticed in East Asia, North America, and Western Europe.
Within the USA, the prevalence of coronary heart failure was estimated to be 2.5% amongst adults, whereas in Canada, it was 3.5% in 2022. In Europe, the estimated prevalence was 1.7% throughout 13 international locations in 2019. The best prevalence was noticed in Germany and Lithuania, and the bottom was noticed in Greece, the Netherlands, Spain, and the UK. Nevertheless, in Spain, estimates of coronary heart failure prevalence have ranged from 2.6% to six.8%, relying on the inhabitants studied and the care setting.
Within the USA, coronary heart failure with preserved ejection fraction has been observed in roughly 50% of all coronary heart failure sufferers prior to now decade. In distinction, a relatively decrease prevalence of coronary heart failure with preserved ejection fraction has been noticed in European international locations, the place coronary heart failure with diminished ejection fraction stays the predominant subtype.
Within the USA, a discount and an induction in coronary heart failure prevalence have been noticed amongst older adults and younger adults, respectively, prior to now decade. Relating to gender-related variations, a better world prevalence of coronary heart failure has been noticed in girls (35 million) than in males (29 million).
Relating to race- and ethnicity-related variations, the very best prevalence of coronary heart failure between 2013 and 2016 has been noticed amongst non-Hispanic Black adults, adopted by non-Hispanic White adults and Mexican American adults.
Prevalence of coronary heart failure in Asia and Australia
The estimated prevalence of coronary heart failure in Asia and Oceania is 722 per 100,000 inhabitants, with East Asia having the very best prevalence and South Asia having the bottom prevalence in 2019. Notably, Japan, South Korea, and Thailand have the bottom prevalence in Asia (<1%).
Contemplating left ventricular ejection fraction, coronary heart failure with diminished ejection fraction has been noticed in 81% of all coronary heart failure sufferers in Asia.
Prevalence of coronary heart failure in Africa and South America
The estimated prevalence of coronary heart failure in South America was 1% between 1994 and 2014. Though no population-level estimates are presently accessible for African international locations, information obtained from 5 African international locations exhibits that 53.7% of sufferers have coronary heart failure with diminished ejection fraction, 30.1% have coronary heart failure with mildly diminished ejection fraction, and 16.2% have coronary heart failure with preserved ejection fraction.
International incidence of coronary heart failure
Over the previous decade, the worldwide incidence of coronary heart failure has decreased. Nevertheless, this discount varies considerably by area and demographic. Within the USA, coronary heart failure sufferers aged 65 years and above have skilled a discount from 36 instances per 1,000 people in 2011 to 26 instances per 1,000 people in 2016. An identical discount has been observed in Cabada.
In Europe, the incidence of coronary heart failure ranges from 1.99 in Italy to six.55 in Germany per 1000 person-years. Within the UK, a 7% discount within the incidence of coronary heart failure was noticed between 2002 and 2014.
A better incidence of coronary heart failure has been observed in girls in comparison with males within the USA and Europe. Nevertheless, the incidence of coronary heart failure with preserved ejection fraction is considerably larger in girls than males in Europe.
Within the USA, the very best incidence has been noticed in non-Hispanic Black adults, adopted by Hispanic adults, White adults, and Chinese language American adults. Within the UK, a 61% larger threat of incident coronary heart failure has been noticed amongst people with the bottom socioeconomic standing.
In Australia, the annual incidence of coronary heart failure was 0.348% between 2013 and 2018. In China, the age-standardized incidence was 275 per 100,000 person-years in 2017.
In South America, an incidence of 1.99 instances per 1000 person-years and 5.57 instances per 1000 person-years have been reported in Brazil and Argentina, respectively.
Mortality charge
A variation in coronary heart failure-related mortality has been noticed throughout geographical areas and populations, which may very well be as a result of variations in healthcare entry, financial sources, inhabitants well being profiles, and scientific administration practices.
A scientific assessment involving 1.5 million coronary heart failure sufferers has proven that the 1-year, 2-year, 5-year, and 10-year survival charges of coronary heart failure are 87%, 73%, 57%, and 35%, respectively. A scientific assessment involving 1.5 million coronary heart failure sufferers has proven that the 1-year, 2-year, 5-year, and 10-year survival charges of coronary heart failure are 87%, 73%, 57%, and 35%, respectively.
Comparatively larger mortality has been noticed in Black adults in comparison with that in different races and ethnicities. Within the USA, age-adjusted mortality in younger adults has elevated from 2.36 in 1999 to three.16 in 2019, which is a extra important rise than that in older adults.
