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Long-term trends in first hospitalization for heart failure and subsequent survival between 1986 and 2003: a population study of 5.1 million people.
Circulation. 2009 Feb 03; 119(4):515-23.Circ

Abstract

BACKGROUND

We examined whether population-level hospitalization rates for heart failure (HF) and subsequent survival have continued to improve since the turn of the century. We also examined trends in the prescribing of evidence-based pharmacological treatment for HF.

METHODS AND RESULTS

All patients in Scotland hospitalized with a first episode of HF between 1986 and 2003 were followed up until death or the end of 2004. Prescriptions of evidence-based treatments issued from 1997 to 2003 by a sample of primary care practices were also examined. A total of 116 556 individuals (52.6% women) had a first hospital discharge for HF. Age-adjusted first hospitalization rates for HF (per 100 000; 95% CI in parentheses) rose from 124 (119 to 129) in 1986 to 162 (157 to 168) in 1994 and then fell to 105 (101 to 109) in 2003 in men; in women, they rose from 128 (123 to 132) in 1986 to 160 (155 to 165) in 1993, falling to 101 (97 to 105) in 2003. Case-fatality rates fell steadily over the period. Adjusted 30-day case-fatality rates fell after discharge (adjusted odds [2003 versus 1986] 0.59 [95% CI 0.45 to 0.63] in men and 0.77 [95% CI 0.67 to 0.88] in women). Adjusted 1- and 5-year survival improved similarly. Median survival increased from 1.33 to 2.34 years in men and from 1.32 to 1.79 years in women. Age-adjusted prescribing rates for angiotensin-converting enzyme inhibitors, beta-blockers, and spironolactone increased from 1997 to 2003 (all P<0.0001 for trend).

CONCLUSIONS

After rising between 1986 and 1994, rates of first hospitalization for HF declined. Case-fatality rates also fell. Prescribing rates for HF therapies increased from 1997 to 2003. These findings suggest that improvements in the prevention and treatment of HF may have had progressive, sustained effects on outcomes at the population level; however, prognosis remains poor in HF.

Authors+Show Affiliations

BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, G12 8TA, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19153268

Citation

Jhund, Pardeep S., et al. "Long-term Trends in First Hospitalization for Heart Failure and Subsequent Survival Between 1986 and 2003: a Population Study of 5.1 Million People." Circulation, vol. 119, no. 4, 2009, pp. 515-23.
Jhund PS, Macintyre K, Simpson CR, et al. Long-term trends in first hospitalization for heart failure and subsequent survival between 1986 and 2003: a population study of 5.1 million people. Circulation. 2009;119(4):515-23.
Jhund, P. S., Macintyre, K., Simpson, C. R., Lewsey, J. D., Stewart, S., Redpath, A., Chalmers, J. W., Capewell, S., & McMurray, J. J. (2009). Long-term trends in first hospitalization for heart failure and subsequent survival between 1986 and 2003: a population study of 5.1 million people. Circulation, 119(4), 515-23. https://doi.org/10.1161/CIRCULATIONAHA.108.812172
Jhund PS, et al. Long-term Trends in First Hospitalization for Heart Failure and Subsequent Survival Between 1986 and 2003: a Population Study of 5.1 Million People. Circulation. 2009 Feb 3;119(4):515-23. PubMed PMID: 19153268.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term trends in first hospitalization for heart failure and subsequent survival between 1986 and 2003: a population study of 5.1 million people. AU - Jhund,Pardeep S, AU - Macintyre,Kate, AU - Simpson,Colin R, AU - Lewsey,James D, AU - Stewart,Simon, AU - Redpath,Adam, AU - Chalmers,James W T, AU - Capewell,Simon, AU - McMurray,John J V, Y1 - 2009/01/19/ PY - 2009/1/21/entrez PY - 2009/1/21/pubmed PY - 2009/3/5/medline SP - 515 EP - 23 JF - Circulation JO - Circulation VL - 119 IS - 4 N2 - BACKGROUND: We examined whether population-level hospitalization rates for heart failure (HF) and subsequent survival have continued to improve since the turn of the century. We also examined trends in the prescribing of evidence-based pharmacological treatment for HF. METHODS AND RESULTS: All patients in Scotland hospitalized with a first episode of HF between 1986 and 2003 were followed up until death or the end of 2004. Prescriptions of evidence-based treatments issued from 1997 to 2003 by a sample of primary care practices were also examined. A total of 116 556 individuals (52.6% women) had a first hospital discharge for HF. Age-adjusted first hospitalization rates for HF (per 100 000; 95% CI in parentheses) rose from 124 (119 to 129) in 1986 to 162 (157 to 168) in 1994 and then fell to 105 (101 to 109) in 2003 in men; in women, they rose from 128 (123 to 132) in 1986 to 160 (155 to 165) in 1993, falling to 101 (97 to 105) in 2003. Case-fatality rates fell steadily over the period. Adjusted 30-day case-fatality rates fell after discharge (adjusted odds [2003 versus 1986] 0.59 [95% CI 0.45 to 0.63] in men and 0.77 [95% CI 0.67 to 0.88] in women). Adjusted 1- and 5-year survival improved similarly. Median survival increased from 1.33 to 2.34 years in men and from 1.32 to 1.79 years in women. Age-adjusted prescribing rates for angiotensin-converting enzyme inhibitors, beta-blockers, and spironolactone increased from 1997 to 2003 (all P<0.0001 for trend). CONCLUSIONS: After rising between 1986 and 1994, rates of first hospitalization for HF declined. Case-fatality rates also fell. Prescribing rates for HF therapies increased from 1997 to 2003. These findings suggest that improvements in the prevention and treatment of HF may have had progressive, sustained effects on outcomes at the population level; however, prognosis remains poor in HF. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/19153268/Long_term_trends_in_first_hospitalization_for_heart_failure_and_subsequent_survival_between_1986_and_2003:_a_population_study_of_5_1_million_people_ L2 - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.108.812172?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -