Heart failure in Poland: a 20-year epidemiological perspective

Abstract Background/Introduction Cardiovascular diseases (CVD) remain the leading cause of mortality in Poland, with heart failure (HF) representing a significant public health burden. Given the evolving epidemiology of HF, a long-term comparative analysis of HF-related healthcare trends is warranted. Purpose This study aimed to analyze trends in HF incidence, hospitalization rates, patient demographics, and mortality over two decades, highlighting changes in the epidemiological profile of HF patients and assessing the impact of healthcare interventions. Methods A comparative analysis was conducted using data from two national reports: (1) the 2013 report "Heart Failure – Analysis of Economic and Social Costs", evaluating HF patients from 2004-2012, and (2) the 2023 report "Heart Failure in Poland 2014-2021", based on data from the Polish Ministry of Health, National Health Fund, and HTA Consulting. The study examined HF prevalence (ICD-10: I50, J81), hospitalization rates, comorbidities, mortality trends, and access to rehabilitation. Results Between 2014 and 2019, the number of HF patients increased by 34%, reaching 1.02 million in 2019. Only 9% of HF patients were younger than 60 years. Multimorbidity was highly prevalent, with hypertension, atherosclerotic cardiovascular disease, arrhythmias, and cerebrovascular disease frequently preceding HF diagnosis. In 2019, HF-related hospitalizations increased by 41% compared to 2014, reflecting a rise in disease exacerbations and readmissions. HF-related mortality increased, with 149,963 deaths (30% of total cardiovascular deaths) in 2021, compared to 16,606 in 2012. The economic burden of HF care rose by 117% between 2014 and 2020, with hospitalizations accounting for 94% of total costs, compared to 65% in 2012. Access to post-hospitalization rehabilitation remained limited, with only 1 in 28 HF patients receiving rehabilitation in 2019, compared to 1 in 22 in 2012. Conclusion(s) Over the past two decades, HF prevalence and mortality have increased in Poland, accompanied by a rising burden of multimorbidity. The increasing hospitalization rates emphasize the need for improved outpatient management. Declining participation in rehabilitation programs, despite growing HF incidence, underscores the necessity of expanding access to post-hospitalization care. Changes in patient demographics and escalating healthcare costs highlight the need for comprehensive HF care strategies, including early detection, optimized pharmacotherapy, and broader access to advanced therapies. These findings provide a foundation for future healthcare planning to mitigate the impact of HF in Poland.