Incidence and aetiology of heart failure; a population-based study

TLDR

Heart failure cases were identified in a population of 151,000 in Hillingdon, West London via acute hospital admission surveillance and a GP‑referenced rapid access clinic. Over 20 months, 220 new heart failure cases were identified, yielding a crude incidence of 1.3 per 1,000 per year that rose with age (from 0.02 at 25–34 to 11.6 at 85+), was higher in males (age‑adjusted IRR 1.75), had a median age of 76, and the main etiologies were coronary heart disease (36 %), unknown (34 %), hypertension (14 %), valve disease (7 %), atrial fibrillation (5 %) and other (5 %).

Abstract

New cases of heart failure were identified from a population of 151000 served by 82 general practitioners in Hillingdon, West London through surveillance of acute hospital admissions and through a rapid access clinic to which general practitioners referred all new cases of suspected heart failure. On the basis of clinical assessment, electrocardiography, chest radiography and transthoracic echocardiography, a panel of three cardi-ologists decided that 220 patients met the case definition of new heart failure over a 20 month period (crude incidence rate of 1·3 cases per 1000 population per year for those aged 25 years or over). The incidence rate increased from 0·02 cases per 1000 population per year in those aged 25–34 years to 11·6 in those aged 85 years and over. The incidence was higher in males than females (age-adjusted incidence ratio 1·75 [95% confidence interval 1·34–2·29,P<0·0001]). The median age at presentation was 76 years. The primary aetiologies were coronary heart disease (36%), unknown (34%), hypertension (14%), valve disease (7%), atrial fibrillation alone (5%), and other (5%).