Heart failure: an epidemic of the 21st century

Abstract

Heart failure is the leading cause of hospital admission in patients over the age of 65 in the United States and one of the leading causes of morbidity, mortality, and resource utilization in this country. This diagnosis carries an ominous prognosis worse than most cancers, and the financial burden exceeds 25 billion dollars a year. With the aid of a plethora of drugs, devices, and complementary therapies, heart failure management and outcomes have improved. However, as the country ages and more people survive their myocardial infarctions, as well as develop hypertension and diabetes, the incidence of heart failure continues to escalate. Heart failure has become such a broad epidemic that the American College of Cardiology, in collaboration with the American Heart Association, has developed new guidelines to prevent the development of systolic heart failure, thus changing the emphasis from clinical assessment to detection, intervention, and prevention. Hypertension and diabetes mellitus, in particular, are targeted as major risk factors for heart failure. These guidelines consist of 4 stages and provide objective categorization and evidence-based treatment recommendations from the literature for each of the stages. Inroads were made in the fight against heart attacks by the formation of care teams. Similarly, care teams for early identification of patients at risk, development of algorithms and critical pathways, and practicing evidence-based medicine are all within our capabilities for the battle against heart failure. Toward this end, the National Coalition for the Management of Left Ventricular Dysfunction has been formed and invites you to join in this comprehensive project to impact on the course of the heart failure epidemic at www.nclvd.org.