Heart failure burden in Kazakhstan among adults: data from Unified National Electronic Healthcare System 2014-19

Abstract

Heart failure (HF) is a complex clinical syndrome with significant mortality risks, causing an increasing healthcare burden. Globally, 64.3 million prevalent cases were estimated in 2017. This research examines HF epidemiology in the adult population in Kazakhstan, the largest country in Central Asia. The retrospective analysis was performed on data from the Unified National Electronic Health System, involving 526 766 individuals registered with HF between 2014 and 2019. In the cohort, women accounted for 54% and men for 46%, and the majority (87%) were aged 50 or above. The most prevalent comorbid conditions were hypertension (46%), cerebrovascular diseases (32%), and atherosclerotic heart disease (23%). While the incidence rate declined over the observation period, the all-cause mortality rate almost tripled from 356 to 975 people per million population during the observation period. Of the cohort, 14% of the patients (71 591) were recorded as deceased. In 2019, HF in Kazakhstan resulted in the loss of 2364789.8 disability-adjusted life years. Premature death accounted for a major portion, with 1337578.9 years of life lost. Males have a higher risk of death compared to females [hazard ratio (HR) = 1.24, 95% confidence interval (CI): 1.23-1.26]. History of acute myocardial infarction increases the risk of death by 69% (HR = 1.69, 95% CI: 1.67-1.73) and diabetes by 14% (HR = 1.14, 95% CI: 1.12-1.16) after adjustment for other variables. This research evaluated the burden and disability-adjusted life years of HF in Kazakhstan. The results show that more effective disease management systems and preventive measures for the elderly are needed.

Figure 1.

Age and sex-specific HF incidence rate per 1 000 000 population in 2014 and 2019.

Figure 2.

Prevalence, incidence, and all-cause mortality of HF patients in Kazakhstan in 2014–19 by years: (a) absolute numbers; (b) rates per million population.