Heart Failure Survival Among Older Adults in the United States

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Abstract
DURING the past 2 decades, heart failure has emerged as a major chronic disease for older US adults.1-6 Almost 75% of nearly 5 million patients with heart failure in the United States are older than 65 years.1 As the progressive aging of the US population continues during the next 40 years, the number of heart failure patients older than 65 years is expected to double.2 Heart failure is already the leading principal hospital diagnosis among older adults.2 Furthermore, more than 90% of deaths with heart failure as the underlying cause occur among adults 65 years or older.3 These statistics take on special importance to the Medicare plan and the aging population because hospitalizations and death rates for heart failure increased among older adults between 1980 and 1990,3-6 despite declines in death rates for ischemic heart disease (IHD)7 and cerebrovascular disease8 and improvements in the treatment of hypertension.9 It is not yet clear whether recent changes in the definition, diagnosis, and pharmacological management of heart failure10-16 have had any impact on national survival estimates.