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Heart Failure Rates Rise since 1970s

Tuesday, February 14, 2006

The incidence of heart failure has risen among the elderly, possibly due to improved survival of coronary disease from better surgical and medical treatments, according to a University of Rochester-led study in this month’s Circulation: Journal of the American Heart Association.

In a retrospective study of medical records of thousands of patients between the 1970s and 1990s, the researchers also observed that survival time with heart failure improved more in men than in women. Women have more co-existing medical conditions such as diabetes, cancer and chronic lung disease, and more women than men were in nursing homes, an indication of frailty, the study said.

“The recent death of well-known author and feminist Betty Friedan, at age 85 of congestive heart failure, reminds us that as people reach their outer limits, this is a prevailing reason why people die,” said lead author William H. Barker, M.D., professor emeritus of Community and Preventive Medicine and of Gerontology at the University of Rochester Medical Center.

“Heart failure has become the most common hospital discharge diagnosis for men and women over age 65,” Barker added. “This disabling and costly condition deserves to be the highest research priority so that we can learn more about precipitating factors and its management.”

The incidence of heart failure jumped 14 percent during the study period. And while the incidence rates increased for both sexes at about the same rate, the death rates fell between the two periods by 33 percent for men and 24 percent for women, the study showed.

The study was done at the request of The National Heart, Lung and Blood Institute, which convened a special panel and funded the review of population trends. The goal was to examine why heart failure has reached epidemic levels.

Barker and his group studied two subsets of patients: individuals aged 65 or older enrolled in an HMO in Portland, Oregon, between 1970 and 1974, and the same age group enrolled at the same HMO from 1990 to 1994.

The study was based at the Kaiser Permanente Center for Health Research in Portland, which has maintained medical records for research since 1966. Portland’s heart failure hospitalization and death rates also tend to mirror national data, the study said. Co-authors and collaborators from Kaiser were John P. Mullooly, Ph.D., and William Getchell, M.D.

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