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Prevalence of heart failure and systolic ventricular dysfunction in older Australians: the Canberra Heart Study.

Abstract

OBJECTIVE

To estimate the prevalence of heart failure (HF) and left ventricular (LV) systolic dysfunction in a population-based sample of older Australians.

DESIGN, SETTING AND PARTICIPANTS

A cross-sectional survey of 2000 randomly selected residents of Canberra, aged 60-86 years, conducted between February 2002 and June 2003. Participants were assessed by history, physical examination by a cardiologist, and echocardiography.

MAIN OUTCOME MEASURES

Age- and sex-specific prevalence rates of clinical HF and LV systolic dysfunction (defined as LV ejection fraction < or = 50%).

RESULTS

Of 1846 people eligible for our study, 1388 (75%) agreed to participate and 1275 completed all investigations (mean age, 69.4 years; 50% men). In the study sample, 72 subjects (5.6%; 95% CI, 4.4%-7.1%) had clinical HF that had been previously diagnosed and was confirmed by our assessment. A further 0.6% (95% CI, 0.3%-1.2%) had undiagnosed clinical HF (ie, evidence of structural heart disease and symptoms/signs of cardiac insufficiency without a previous diagnosis of clinical HF). Thus, the overall prevalence of clinical HF in the sample was 6.3% (95% CI, 5.0%-7.7%). Clinical HF increased in prevalence with advancing age (a 4.4-fold increase from the 60-64-years age group to the 80-86-years age group; P < 0.0001). Of the 75 subjects (5.9%; 95% CI, 4.7%-7.3%) with LV systolic dysfunction, 44 (59%) were in the preclinical stage of disease.

CONCLUSION

Diagnosed HF cases represent the "tip of the iceberg" for the national burden of HF and LV systolic dysfunction. Clinically identifiable HF cases can remain undiagnosed, and the majority of people with LV systolic dysfunction are in a preclinical stage of the disease.

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  • Authors+Show Affiliations

    ,

    Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. abhayaratna.walter@mayo.edu

    , , , ,

    Source

    The Medical journal of Australia 184:4 2006 Feb 20 pg 151-4

    MeSH

    Age Factors
    Aged
    Aged, 80 and over
    Australian Capital Territory
    Body Mass Index
    Cross-Sectional Studies
    Data Interpretation, Statistical
    Echocardiography
    Female
    Heart Failure
    Humans
    Male
    Middle Aged
    Random Allocation
    Sex Factors
    Surveys and Questionnaires
    Systole
    Ventricular Dysfunction, Left

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    16489896

    Citation

    Abhayaratna, Walter P., et al. "Prevalence of Heart Failure and Systolic Ventricular Dysfunction in Older Australians: the Canberra Heart Study." The Medical Journal of Australia, vol. 184, no. 4, 2006, pp. 151-4.
    Abhayaratna WP, Smith WT, Becker NG, et al. Prevalence of heart failure and systolic ventricular dysfunction in older Australians: the Canberra Heart Study. Med J Aust. 2006;184(4):151-4.
    Abhayaratna, W. P., Smith, W. T., Becker, N. G., Marwick, T. H., Jeffery, I. M., & McGill, D. A. (2006). Prevalence of heart failure and systolic ventricular dysfunction in older Australians: the Canberra Heart Study. The Medical Journal of Australia, 184(4), pp. 151-4.
    Abhayaratna WP, et al. Prevalence of Heart Failure and Systolic Ventricular Dysfunction in Older Australians: the Canberra Heart Study. Med J Aust. 2006 Feb 20;184(4):151-4. PubMed PMID: 16489896.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Prevalence of heart failure and systolic ventricular dysfunction in older Australians: the Canberra Heart Study. AU - Abhayaratna,Walter P, AU - Smith,Wayne T, AU - Becker,Niels G, AU - Marwick,Thomas H, AU - Jeffery,Ian M, AU - McGill,Darryl A, PY - 2005/04/20/received PY - 2005/10/20/accepted PY - 2006/2/24/pubmed PY - 2006/3/21/medline PY - 2006/2/24/entrez SP - 151 EP - 4 JF - The Medical journal of Australia JO - Med. J. Aust. VL - 184 IS - 4 N2 - OBJECTIVE: To estimate the prevalence of heart failure (HF) and left ventricular (LV) systolic dysfunction in a population-based sample of older Australians. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional survey of 2000 randomly selected residents of Canberra, aged 60-86 years, conducted between February 2002 and June 2003. Participants were assessed by history, physical examination by a cardiologist, and echocardiography. MAIN OUTCOME MEASURES: Age- and sex-specific prevalence rates of clinical HF and LV systolic dysfunction (defined as LV ejection fraction < or = 50%). RESULTS: Of 1846 people eligible for our study, 1388 (75%) agreed to participate and 1275 completed all investigations (mean age, 69.4 years; 50% men). In the study sample, 72 subjects (5.6%; 95% CI, 4.4%-7.1%) had clinical HF that had been previously diagnosed and was confirmed by our assessment. A further 0.6% (95% CI, 0.3%-1.2%) had undiagnosed clinical HF (ie, evidence of structural heart disease and symptoms/signs of cardiac insufficiency without a previous diagnosis of clinical HF). Thus, the overall prevalence of clinical HF in the sample was 6.3% (95% CI, 5.0%-7.7%). Clinical HF increased in prevalence with advancing age (a 4.4-fold increase from the 60-64-years age group to the 80-86-years age group; P < 0.0001). Of the 75 subjects (5.9%; 95% CI, 4.7%-7.3%) with LV systolic dysfunction, 44 (59%) were in the preclinical stage of disease. CONCLUSION: Diagnosed HF cases represent the "tip of the iceberg" for the national burden of HF and LV systolic dysfunction. Clinically identifiable HF cases can remain undiagnosed, and the majority of people with LV systolic dysfunction are in a preclinical stage of the disease. SN - 0025-729X UR - https://www.unboundmedicine.com/medline/citation/16489896/full_citation L2 - https://www.mja.com.au/public/issues/184_04_200206/abh10296_fm.html DB - PRIME DP - Unbound Medicine ER -