TY - JOUR
T1 - Congestive heart failure in the community
T2 - A study of all incident cases in Olmsted county, Minnesota, in 1991
AU - Senni, Michele
AU - Tribouilloy, Christophe M.
AU - Rodeheffer, Richard J.
AU - Jacobsen, Steven J.
AU - Evans, Jonathan M.
AU - Bailey, Kent R.
AU - Redfield, Margaret M.
PY - 1998/11/24
Y1 - 1998/11/24
N2 - 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.
AB - 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.
KW - Epidemiology
KW - Heart failure
KW - Prognosis
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U2 - 10.1161/01.CIR.98.21.2282
DO - 10.1161/01.CIR.98.21.2282
M3 - Article
C2 - 9826315
AN - SCOPUS:0032564326
SN - 0009-7322
VL - 98
SP - 2282
EP - 2289
JO - Circulation
JF - Circulation
IS - 21
ER -