Epidemiology

Heart failure is a global disease. The prevalence of known heart failure in the developed world has been estimated at 1% to 2%, and the incidence is thought to approach 1 to 9 per 1000 people per year.[4] The prevalence of heart failure is about 1.3% in China, 6.7% in Malaysia, 1.0% in Japan, 4.5% in Singapore, 0.12% to 0.44% in India, and 1.0% in South America.[5] In Australia, the prevalence of heart failure is consistent with other developed countries at 1% to 2%; however, following age-standardisation, the prevalence of heart failure is 1.7 times higher among Indigenous than non-Indigenous Australians.[6] In the UK, heart failure is thought to account for a total of 1 million inpatient bed days and 5% of all emergency admissions. These figures are projected to rise by as much as 50% in the next 25 years.[7]

The total prevalence of heart failure in the US is between 1.5% and 1.9%.[5] From 2013 to 2016, an estimated 6.2 million adults aged ≥20 years had heart failure in the US.[8] In 2014 there were 1 million new cases in patients aged >55 years.[8] Heart failure is the primary reason for 12 to 15 million clinic visits and 6.5 million hospital-days each year.[9][10] Recurrent hospitalisation is a major quality of life and cost issue: for example, from 1990 to 1999, the annual number of hospitalisations increased from approximately 810,000 to over 1 million for primary diagnosis and from 2.4 million to 3.6 million for primary or secondary diagnosis.[11] Patients are particularly prone to re-admission, with reported rates as high as 50% within 6 months of discharge.

Worldwide the absolute numbers of people living with heart failure are increasing.[4] The rising prevalence of heart failure is not necessarily linked with an increase in heart failure incidence, as the incidence appears to be stable or decreasing in some countries, in part due to better treatment and reduced mortality of patients with acute myocardial infarctions earlier in life.[5][4] Heart failure is primarily a condition of older people, and thus the widely recognised 'ageing of the population' contributes to its increasing prevalence.[4]

The prevalence of heart failure increases with increasing age. In the US, among patients aged 40 to 59 years the prevalence of heart failure is about 1.2% in males and 1.7% in females, whereas among patients aged ≥80 years the prevalence of heart failure is about 12.8% in males and 12% in females.[8] A major heart study conducted in Australia in 2006 found that 6.3% of older residents (aged 60–86 years ) in Canberra had overt symptomatic heart failure, and there was an even higher proportion of people with subclinical heart failure.[12]

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