Key result
Heart failure incidence in England rises ~20% between 2015 and 2019.
Why the study?
Data on HF subtypes in broad populations are lacking, and whether current HF incidence and prevalence rates match historical data remains unknown.
Cohort (n=383,896)
Between 2015 and 2019, the incidence and prevalence of heart failure in England increased modestly, though primary care recording of HF subtype remains suboptimal with over 70% of patients lacking subtype data.
Rising HF incidence in England with HFrEF predominance informs planning; extends historical data but leaves subtype outcomes open.
BACKGROUND: Heart failure (HF) is associated with high morbidity and mortality, yet data on HF subtype (HF with reduced ejection fraction [HFrEF] and preserved ejection fraction [HFpEF]) in broad populations are lacking. Additionally, it is unknown whether current HF incidence and prevalence rates are consistent with historical data. Here, we estimate the incidence and prevalence of HF in England and describe the characteristics of patients with HF, both overall and by subtype. METHODS: December 2019 formed the base cohort, from which patients with a recorded chronic HF diagnosis (historical or incident) from 2015-2019 contributed to the incidence and prevalence calculations. RESULTS: The eligible denominator over the study period comprised 11,414,490 patients, from which 383,896 patients with HF were included as prevalent or incident HF cases. From 2015 to 2019, the incidence rate of newly diagnosed HF increased from 4.1/1,000 person-years to 4.9/1,000 person-years, and HF prevalence increased from 2.1% to 2.4%. Phenotype data were available for 100,224 (26.1%) patients, of which 68,780 patients had HFrEF and 31,444 had HFpEF (HFrEF/HFpEF ratio: 70.1%/29.9%). Comorbidity levels were high and broadly similar across HF subgroups. CONCLUSIONS: Primary care recording of HF subtype is suboptimal, with more than 7/10 patients with HF lacking subtype data. In patients with a recorded subtype (n = 100,224), a HFrEF/HFpEF ratio of 70%/30% was observed. Comorbidity levels were high regardless of subtype. Between 2015 and 2019, we observed modest but consistent increases in the incidence and prevalence of chronic HF in adults, in line with historical data.
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Bellanca et al. (2023) conducted a cohort in Heart failure (n=383,896). Heart failure was evaluated on Overall incidence rate of heart failure per 1,000 person-years (95% CI 4.45-4.49). Between 2015 and 2019, the incidence rate of newly diagnosed heart failure in England increased from 4.1 to 4.9 per 1,000 person-years, and prevalence increased from 2.1% to 2.4%.
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