Epidemiology of Incident Heart Failure in a Contemporary Elderly Cohort

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Abstract
Heart failure (HF) is primarily a disease of older persons, with an annual incidence of 10 cases per 1000 after age 65 years, which doubles every decade thereafter.1 Subjects older than 65 years represent more than 75% of prevalent HF cases in the United States.2 In a 2004 European study,3 participants older than 70 years accounted for 88% of new HF cases. Although some recent data suggest relative improvement in survival after development of HF,4,5 other evidence challenges this finding, especially in older persons.6 Nevertheless, the absolute survival rate for these patients remains poor, and the actual number of HF deaths has increased by 20.5% during the last decade, reflecting the increasing prevalence of HF and the aging of the population. In patients older than 67 years, the median survival is generally less than 3 years after hospitalization for HF.7,8 The annual hospitalization rate for these patients now exceeds 1 million in the United States, 80% of patients hospitalized with HF are older than 65 years, and readmission rates as high as 50% within 6 months of discharge have been reported.9