Congestive heart failure in the community: A study of all incident cases in Olmsted county, Minnesota, in 1991

Michele Senni, Christophe M. Tribouilloy, Richard J. Rodeheffer, Steven J. Jacobsen, Jonathan M. Evans, Kent R. Bailey, Margaret M. Redfield

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Abstract

Background - Data are limited regarding the classification and prognosis of patients with congestive heart failure (CHF) in the community. Methods and Results - Using the resources of the Rochester Epidemiology Project, we evaluated all patients receiving a first diagnosis of CHF in Olmsted County, Minnesota, in 1991 (n=216). Among these patients, 88% were ≥65 years and 49% were ≥80 years of age. The prognosis of patients with a new diagnosis of CHF was poor; survival was 86±2% at 3 months, 76±3% at 1 year, and 35±3% at 5 years. Of the 216 patients, 137 (63%) had an assessment of ejection fraction. In these patients, systolic function was preserved (ejection fraction ≥50%) in 59 (43%) and reduced (ejection fraction <50%)in 78 (57%). Survival adjusted for age, sex, NYHA class, and coronary artery disease was not significantly different between patients with preserved and those with reduced systolic function (relative risk, 0.80; P=0.369). ACE inhibitors were used in only 44% of the total population with CHF. Conclusions - The present study reports the clinical characteristics and natural history of CHF as it presents in the community in the vasodilator era. CHF is a disease of the 'very elderly,' frequently occurs in the setting of normal ejection fraction, and has a poor prognosis, regardless of the level of systolic function. Diagnostic and therapeutic methods are underused in the community.

Original languageEnglish (US)
Pages (from-to)2282-2289
Number of pages8
JournalCirculation
Volume98
Issue number21
DOIs
StatePublished - Nov 24 1998

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Keywords

  • Epidemiology
  • Heart failure
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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