Copyright © 2001 by the European Society of Cardiology.
The prognosis of heart failure in the general population. The Rotterdam Study
a Department of Epidemiology and Biostatistics, Erasmus Medical Centre, Rotterdam, The Netherlands
b Department of Cardiology/Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands
f Department of Medical Informatics, Erasmus Medical Centre, Rotterdam, The Netherlands
c Department of General Practice, Erasmus Medical Centre, Rotterdam, The Netherlands
d the Julius Centre for Patient Oriented Research, Utrecht University, The Netherlands
e Department of General Practice, Utrecht University, The Netherlands
revised November 7, 2000; accepted November 8, 2000
Abstract
Aims To determine the prognosis, cause of death, and its determinants in participants of the population-based Rotterdam Study who were found to have heart failure.
Methods and Results In 5255 Rotterdam Study participants (aged 68·9±8·6 years, 3113 women) the presence of heart failure was determined. Data were analysed with Cox's proportional-hazards models. One hundred and eighty-one participants (age 77·3±7·9 years, 109 women) had heart failure. Of these 85 (47%) died during the 4·8–8·5 (mean 6·1) years of follow-up. One, 2 and 5 years' survival was 89%, 79%, and 59%, representing an age-adjusted mortality twice that of persons without heart failure (hazard ratio 2·1, 95% CI 1·8–2·7). The hazard ratio for sudden death was even more pronounced: 4·8, (95% CI 2·6–8·7). Diabetes mellitus, impairment of renal function and atrial fibrillation were associated with a poor outcome. A higher blood pressure and body mass index conferred a more favourable prognosis in those with heart failure.
Conclusion Heart failure generally afflicts older subjects in the community, carries a poor prognosis, especially in the presence of concomitant diseases, and confers a fivefold increase in the risk of sudden death.
Key Words: Heart failure, epidemiology, diabetes mellitus, prognosis, sudden death, mortality
f1 Correspondence: Arend Mosterd, PhD, Department of Cardiology, Eemland Hospital, Utrechtseweg 160, 3818 ES Amersfoort, The Netherlands.
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