Heart failure hospitalization rates rise dramatically among U.S. seniors

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NEW ORLEANS—Heart failure is reaching epidemic levels among seniors in the United States, according to research presented Sunday at the American Heart Association (AHA) Scientific Sessions.

“Both the number of patients hospitalized with a primary diagnosis of heart failure and age-adjusted hospitalization rates for heart failure have increased dramatically over the past 27 years,” said study senior author Longjian Liu, MD, PhD, associate professor of epidemiology and biostatistics of the Drexel University School of Public Health in Philadelphia. “The prevention and treatment of heart failure has become an urgent public health need with national implications.”

An estimated 5.3 million Americans live with heart failure, and 660,000 new cases are diagnosed each year, according to the AHA.

The Drexel study is the first to examine the disease's hospitalization rates over the last 27 years and is the initial portion of a serial report on heart failure epidemiology in the U.S.

The study used data from more than 2.2 million patients, age 65 or older, in the National Hospital Discharge Surveys between 1980 and 2006, which provides annual estimates of hospital discharges in the U.S. In the study, heart failure was defined as patients with a primary diagnosis of heart failure at hospital discharge.

The study also broke the data down into three age groups: 65, 75 and 85 or older by gender, and then estimated statistically the hospitalization rates with census population data in terms of gender and time periods.

Liu and colleagues found the following:

  • The number of patients age 65 and older who were hospitalized for heart failure increased from 348,866 in 1980 to 807,082 in 2006—a 131 percent increase.
  • For men, rates rose from 16.57 hospitalizations per 1,000 members of the population in 1980 to 22.87 in 2006.
  • For women, rates rose from 13.95 hospitalizations per 1,000 members of the population to 19.58 in 2006.
  • Women had a significantly higher annual percentage increase rate than men (55 percent vs. 20 percent).
  • From 2002 to 2006, the relative risk of being hospitalized due to heart failure was 1.37 times higher than it had been from 1980-84.
  • Patients ages 75-84 had twice the risk of being hospitalized for heart failure than those 65-74, and those ages 85 or older had four times more risk of hospitalization for heart failure than those ages 65-74.

The study also showed that, among the three major forms of cardiovascular disease, coronary heart disease and stroke have shown decreases in hospitalization rates since the mid-1980s. However, heart failure has shown a continuously significant increase in hospitalization rates since 1980.

Directly and indirectly, heart failure is expected to cost $34.8 billion in the U.S. this year, according to AHA data. The peak of the crisis is still to come, according to Liu.

“Over the next decades, the number of U.S. adults age 65 and older will double to a projected 70 million, and more than one in five will be 65 or older by the year 2030,” he said. “Because heart failure disproportionately affects the elderly, there is no doubt that the burden of heart failure will increase unless innovative strategies are implemented. The key is to prevent risk factors for the disease.”