Key result
Heart failure linked to ~2-fold higher age-adjusted mortality in the general population.
Why the study?
The prognosis, cause of death, and determinants of heart failure in the general population were not well characterized.
Does the presence of heart failure increase the risk of mortality and sudden death in the general population?
Cohort (n=5,255)
Does the presence of heart failure increase the risk of mortality and sudden death in the general population?
Heart failure in the general population carries a poor prognosis with a twofold increase in all-cause mortality and a nearly fivefold increase in sudden death.
Underscores poor prognosis in community HF; leaves open whether targeted interventions reduce sudden death risk.
AIMS: To determine the prognosis, cause of death, and its determinants in participants of the population-based Rotterdam Study who were found to have heart failure. METHODS AND RESULTS: In 5255 Rotterdam Study participants (aged 68.9+/-8.6 years, 3113 women) the presence of heart failure was determined. Data were analysed with Cox's proportional-hazards models. One hundred and eighty-one participants (age 77.3+/-7.9 years, 109 women) had heart failure. Of these 85 (47%) died during the 4.8-8.5 (mean 6.1) years of follow-up. One, 2 and 5 years' survival was 89%, 79%, and 59%, representing an age-adjusted mortality twice that of persons without heart failure (hazard ratio 2.1, 95% CI 1.8-2.7). The hazard ratio for sudden death was even more pronounced: 4.8, (95% CI 2.6-8.7). Diabetes mellitus, impairment of renal function and atrial fibrillation were associated with a poor outcome. A higher blood pressure and body mass index conferred a more favourable prognosis in those with heart failure. CONCLUSION: Heart failure generally afflicts older subjects in the community, carries a poor prognosis, especially in the presence of concomitant diseases, and confers a fivefold increase in the risk of sudden death.
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Arend Mosterd (2001) conducted a cohort in Heart failure (n=5,255). Heart failure vs. Persons without heart failure was evaluated on Age-adjusted mortality (HR 2.1, 95% CI 1.8-2.7). Heart failure in the general population was associated with twice the age-adjusted mortality of those without heart failure (HR 2.1; 95% CI 1.8-2.7) and a fivefold increased risk of sudden death.
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