Copyright © 1999 by the European Society of Cardiology.
Prevalence of heart failure and left ventricular dysfunction in the general population; The Rotterdam Study
a Department of Epidemiology & Biostatistics, Erasmus University and University Hospital Rotterdam ‘Dijkzigt’ Rotterdam, The Netherlands
b Department of Cardiology, Thoraxcentre, Erasmus University and University Hospital Rotterdam ‘Dijkzigt’ Rotterdam, The Netherlands
e Department of Medical Informatics, Erasmus University and University Hospital Rotterdam ‘Dijkzigt’ Rotterdam, The Netherlands
f the Division of Cardiology, University of Washington, Seattle, U.S.A.
c the Julius Centre for Patient Oriented Research, Utrecht University, Utrecht, The Netherlands
d Department of General Practice, Utrecht University, Utrecht, The Netherlands
revised July 20, 1998; accepted July 22, 1998
Abstract
Aims
To determine the prevalence of heart failure and symptomatic as well as asymptomatic left ventricular systolic dysfunction in the general population.
Methods and Results
In 5540 participants of the Rotterdam Study (age 68·9±8·7 years, 2251 men) aged 55–95 years, the presence of heart failure was determined by assessment of symptoms and signs (shortness of breath, ankle oedema and pulmonary crepitations) and use of heart failure medication. In 2267 subjects (age 65·7±7·4 years, 1028 men) fractional shortening was measured. The overall prevalence of heart failure was 3·9% (95% CI 3·0±4·7) and did not differ between men and women. The prevalence increased with age, with the exception of the highest age group in men. Fractional shortening was higher in women and did not decrease appreciably with age. The prevalence of left ventricular systolic dysfunction (fractional shortening <=25%) was approximately 2·5 times higher in men (5·5%, 95% CI 4·1–7·0) than in women (2·2%, 95% CI 1·4–3·2). Sixty percent of persons with left ventricular systolic dysfunction had no symptoms or signs of heart failure at all.
Conclusions
The prevalence of heart failure is appreciable and does not differ between men and women. The majority of persons with left ventricular systolic dysfunction can be regarded as having asymptomatic left ventricular systolic dysfunction.
Key Words: Heart failure, epidemiology, prevalence, echocardiography, left ventricular dysfunction, asymptomatic
f1 Correspondence: A. Mosterd, MD PhD, Thoraxcentre, Department of Cardiology BD 402, University Hospital ‘Dijkzigt’, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
Julian, DGCamm, AJFox, KFHall, RJCPoole-Wilson, PA
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