Angiotensin converting enzyme inhibition and hospitalisation rates for heart failure in the Netherlands, 1980 to 1999: the end of an epidemic?

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Abstract
All hospital admissions, including in-hospital deaths, with a first listed discharge diagnosis of heart failure were studied, using the methods described in detail previously.2 Briefly, International classification of diseases, ninth revision (ICD-9) codes 428.x (heart failure), 402.x (hypertensive heart disease), and 429.1 (myocardial degeneration) were used to identify discharges for heart failure. Complete national data on discharges were obtained from Prismant and on Dutch population figures from Statistics Netherlands. From 1980 to 1999 the mean age of patients admitted for heart failure increased from 71.2 to 72.9 years in men and from 75.0 to 77.7 years in women. Age adjusted discharge rates were calculated by direct standardisation to the European standard population. Trends over time in discharge rates were analysed separately for men and women using Poisson regression. The model included calendar year, both linear and quadratic, and five year age groups (categorical) as explanatory variables. Nationwide information on ACE inhibition prescription was obtained from IMS Medical Index and Farminform FI-ROM/Aventis, the Netherlands.