Document Detail

Incidence and aetiology of heart failure; a population-based study.
MedLine Citation:
PMID:  10213345     Owner:  NLM     Status:  MEDLINE    
AIMS: To determine the incidence and aetiology of heart failure in the general population. METHODS AND RESULTS: New cases of heart failure were identified from a population of 151 000 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 cardiologists 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%). CONCLUSIONS: Within the general population, new cases of heart failure largely occur in the elderly, and the incidence is higher in men than women. The single most common aetiology is coronary heart disease, but in a third of cases the aetiology cannot be determined on the basis of non-invasive investigation alone. To be relevant to clinical practice, future clinical trials in heart failure should not exclude the elderly.
M R Cowie; D A Wood; A J Coats; S G Thompson; P A Poole-Wilson; V Suresh; G C Sutton
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European heart journal     Volume:  20     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-06-08     Completed Date:  1999-06-08     Revised Date:  2009-09-29    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  421-8     Citation Subset:  IM    
Cardiac Medicine, Imperial College School of Medicine at the National Heart & Lung Institute, London, UK.
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MeSH Terms
Aged, 80 and over
Atrial Fibrillation / complications*
Coronary Disease / complications*
Heart Failure / diagnosis,  epidemiology*,  etiology*
Heart Valve Diseases / complications*
Hypertension / complications*
London / epidemiology
Middle Aged
Population Surveillance*
Reproducibility of Results
Retrospective Studies
Grant Support
//Wellcome Trust
Comment In:
Eur Heart J. 1999 Oct;20(19):1436-7   [PMID:  10487806 ]
Eur Heart J. 1999 Mar;20(6):398-9   [PMID:  10213340 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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