Trends in heart failure prevalence in Japan 2014-2019: a report from healthcare administration databases

Abstract

Aims: Contemporary estimates of heart failure (HF) prevalence in Japan are scarce. We aimed to estimate HF prevalence and trends in Japan using nationally representative, large administrative claims databases.

Methods and results: This retrospective analysis used data from the Japan Medical Data Center (JMDC) (age ≤74 years) and the Medical Data Vision (MDV) (all ages) databases (study period: 1 January 2014-31 December 31 2019). We calculated HF prevalence using crude and sex-/age-standardized models (weighting based on Japanese census data, 2014-2019). Among 8 954 313 individuals aged ≤74 years from JMDC, and 27 920 174 of all ages from MDV, the cumulative 6 year (2014-2019) crude and sex-/age-standardized prevalence of HF per 1000 persons (95% confidence intervals) in Japan was 21.80 [21.70, 21.89] and 41.79 [30.25, 56.11] using JMDC and 65.09 [65.00, 65.18] and 60.95 [46.94, 77.62], respectively, using MDV. We observed an increasing yearly trend in crude HF prevalence per 1000 persons: 11.12 in 2014 and 14.69 in 2019 for JMDC; 58.09 and 77.18, respectively, for MDV. There was an overall increasing trend of comorbidities over time (2014-2019) among HF patients, especially in type 2 diabetes, malignant cancer, chronic kidney disease, and atrial fibrillation. From 2014 to 2019, the percentage of patients in JMDC with type 2 diabetes increased from 15.4% to 20.8% and 23.4% to 31.5% in MDV; malignant cancer frequency increased from 16.5% to 20.1% in JMDC and 18.8% to 23.9% in MDV; frequency of chronic kidney disease increased from 14.8% to 17.7% in JMDC and 18.2% to 22.7% in MDV; and frequency of atrial fibrillation increased from 13.6% to 15.6% in JMDC and 23.8% to 29.0% in MDV.

Conclusions: We estimated that the prevalence of HF in Japan was 2.2-3.7% for patients aged ≤74 during the period 2014-2019 using the JMDC database, while the prevalence for patients of all ages was 6.5% using the MDV database.

Keywords: Database study; Heart failure; Japan; Prevalence.

Figure 1

Age group distribution in HF population by year, using (A) JMDC data (age ≤74 years) and (B) MDV data (all ages). HF, heart failure; JMDC, Japanese Medical Data Center; MDV, Medical Data Vision.

Figure 2

Crude age‐specific HF prevalence by year, age group, and sex, using (A) JMDC data (age ≤74 years) and (B) MDV data (all ages). HF, heart failure; JMDC, Japanese Medical Data Center; MDV, Medical Data Vision.

Figure 3

Yearly trends in comorbidities in the HF population 2014–2019 using (A) JMDC data (age ≤74 years) and (B) MDV data (all ages). Values represent baseline data for each cohort. Baseline comorbidities were defined as presence of ≥1 diagnosis code prior to index date. Chronic kidney disease was defined as code indicating chronic kidney disease (at any time) or two consecutive eGFRs <60 mL/min/1.73 m² in the year prior to index. eGFR, estimated glomerular filtration rate; HF, heart failure; JMDC, Japanese Medical Data Center; MDV, Medical Data Vision.

Figure 4

Prevalence of baseline CVD in each age group by year in HF, heart failure population, using (A) JMDC, Japanese Medical Data Center data (age ≤74 years) and (B) MDV data (all ages). CVD, cardiovascular disease; MDV, Medical Data Vision

Figure 5

Changes in the prevalence of comorbidities at baseline and medication use post index among HF patients between the study years, (A) JMDC (age ≤74 years), (B) MDV (all ages). *Within 3 months prior to index date. Percentage change was calculated as the difference between the percentage of HF patients with each comorbidity between the years. Red represents increase over time (darker red for larger increases) and blue represents decrease over time (darker blue for larger decreases). ACEi, angiotensin‐converting enzyme inhibitor; ARB, angiotensin receptor blocker; HF, heart failure; JMDC, Japanese Medical Data Center; MDV, Medical Data Vision.