Advanced

Age-specific Trends in Incidence, Mortality and Comorbidities of Heart Failure in Denmark 1995-2012

Christiansen, Mia N.; Køber, Lars; Weeke, Peter E.; Vasan, Ramachandran S.; Jeppesen, Jørgen L.; Smith, Gustav J. LU ; Gislason, Gunnar H.; Torp-Pedersen, Christian and Andersson, Charlotte (2017) In Circulation 135(13). p.1214-1223
Abstract

BACKGROUND—: The cumulative burden and importance of cardiovascular risk factors have changed over the last decades. Specifically, obesity rates have increased among younger people, whereas cardiovascular health has improved in the elderly. Little is known regarding how these changes have impacted the incidence and the mortality rates of heart failure. Therefore, we aimed to investigate the age-specific trends in the incidence and 1-year mortality rates following a first time diagnosis of heart failure in Denmark between 1995 and 2012. METHODS—: We included all Danish individuals over the age of 18 years with a first-time in-hospital diagnosis of heart failure. Data was collected from 3 nationwide Danish registries. Annual incidence... (More)

BACKGROUND—: The cumulative burden and importance of cardiovascular risk factors have changed over the last decades. Specifically, obesity rates have increased among younger people, whereas cardiovascular health has improved in the elderly. Little is known regarding how these changes have impacted the incidence and the mortality rates of heart failure. Therefore, we aimed to investigate the age-specific trends in the incidence and 1-year mortality rates following a first time diagnosis of heart failure in Denmark between 1995 and 2012. METHODS—: We included all Danish individuals over the age of 18 years with a first-time in-hospital diagnosis of heart failure. Data was collected from 3 nationwide Danish registries. Annual incidence rates of heart failure and 1-year standardized mortality rates were calculated under the assumption of a Poisson distribution. RESULTS—: We identified 210,430 individuals with a first-time diagnosis of heart failure between 1995 and 2012; the annual incidence rates per 10,000 person-years declined among older individuals (rates in 1995 vs. 2012: 164 vs. 115 in >74 years, 63 vs. 35 in 65-74 years, and 20 vs. 17 in 55-64 years, p<0.0001 for all) but increased among the younger (0.4 vs. 0.7 in 18-34 years, 1.3 vs. 2.0 in 35-44 years, and 5.0 vs. 6.4 in 45-54 years, p<0.0001 for all). The proportion of patients with incident heart failure below 51 years doubled from 3% in 1995 to 6% in 2012 (p<0.0001). Sex- and age-adjusted incidence rate ratios for 2012 vs. 1996 were 0.69 (95%CI 0.67-0.71; p <0.0001) among people >50 years, and 1.52 (95%CI 1.33-1.73; p<0.0001) among individuals ≤50 years; it remained essentially unchanged upon additional adjustment for diabetes, ischemic heart disease, and hypertension. Standardized 1-year mortality rates declined for middle-aged patients with heart failure but remained constant for younger (<45 years) and elderly (≥65 years). The prevalence of comorbidities (including diabetes, hypertension, and atrial fibrillation) increased, especially in younger patients with heart failure. CONCLUSIONS—: Over the last two decades, the incidence of heart failure in Denmark declined among older (>50 years), but increased among younger (≤50 years) individuals. These observations may portend a rising burden of heart failure in the community.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Circulation
volume
135
issue
13
pages
1214 - 1223
publisher
Lippincott Williams and Wilkins
external identifiers
  • scopus:85012926665
  • wos:000397387200013
ISSN
0009-7322
DOI
10.1161/CIRCULATIONAHA.116.025941
language
English
LU publication?
yes
id
60e69c2d-2097-4094-ad5e-58d79aa1630e
date added to LUP
2017-02-27 14:06:07
date last changed
2018-07-08 04:21:51
@article{60e69c2d-2097-4094-ad5e-58d79aa1630e,
  abstract     = {<p>BACKGROUND—: The cumulative burden and importance of cardiovascular risk factors have changed over the last decades. Specifically, obesity rates have increased among younger people, whereas cardiovascular health has improved in the elderly. Little is known regarding how these changes have impacted the incidence and the mortality rates of heart failure. Therefore, we aimed to investigate the age-specific trends in the incidence and 1-year mortality rates following a first time diagnosis of heart failure in Denmark between 1995 and 2012. METHODS—: We included all Danish individuals over the age of 18 years with a first-time in-hospital diagnosis of heart failure. Data was collected from 3 nationwide Danish registries. Annual incidence rates of heart failure and 1-year standardized mortality rates were calculated under the assumption of a Poisson distribution. RESULTS—: We identified 210,430 individuals with a first-time diagnosis of heart failure between 1995 and 2012; the annual incidence rates per 10,000 person-years declined among older individuals (rates in 1995 vs. 2012: 164 vs. 115 in &gt;74 years, 63 vs. 35 in 65-74 years, and 20 vs. 17 in 55-64 years, p&lt;0.0001 for all) but increased among the younger (0.4 vs. 0.7 in 18-34 years, 1.3 vs. 2.0 in 35-44 years, and 5.0 vs. 6.4 in 45-54 years, p&lt;0.0001 for all). The proportion of patients with incident heart failure below 51 years doubled from 3% in 1995 to 6% in 2012 (p&lt;0.0001). Sex- and age-adjusted incidence rate ratios for 2012 vs. 1996 were 0.69 (95%CI 0.67-0.71; p &lt;0.0001) among people &gt;50 years, and 1.52 (95%CI 1.33-1.73; p&lt;0.0001) among individuals ≤50 years; it remained essentially unchanged upon additional adjustment for diabetes, ischemic heart disease, and hypertension. Standardized 1-year mortality rates declined for middle-aged patients with heart failure but remained constant for younger (&lt;45 years) and elderly (≥65 years). The prevalence of comorbidities (including diabetes, hypertension, and atrial fibrillation) increased, especially in younger patients with heart failure. CONCLUSIONS—: Over the last two decades, the incidence of heart failure in Denmark declined among older (&gt;50 years), but increased among younger (≤50 years) individuals. These observations may portend a rising burden of heart failure in the community.</p>},
  author       = {Christiansen, Mia N. and Køber, Lars and Weeke, Peter E. and Vasan, Ramachandran S. and Jeppesen, Jørgen L. and Smith, Gustav J. and Gislason, Gunnar H. and Torp-Pedersen, Christian and Andersson, Charlotte},
  issn         = {0009-7322},
  language     = {eng},
  month        = {02},
  number       = {13},
  pages        = {1214--1223},
  publisher    = {Lippincott Williams and Wilkins},
  series       = {Circulation},
  title        = {Age-specific Trends in Incidence, Mortality and Comorbidities of Heart Failure in Denmark 1995-2012},
  url          = {http://dx.doi.org/10.1161/CIRCULATIONAHA.116.025941},
  volume       = {135},
  year         = {2017},
}