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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O Wendelboe Nielsen, J Hilden, T McDonagh, and J Fischer Hansen Survival differences between heart failure in general practices and in hospitals Heart, November 1, 2003; 89(11): 1298 - 1302. [Abstract] [Full Text] [PDF]
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C. J. Lavie and R. V. Milani Obesity and cardiovascular disease: the hippocrates paradox? J. Am. Coll. Cardiol., August 20, 2003; 42(4): 677 - 679. [Full Text] [PDF]
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J.G.F Cleland, K Swedberg, F Follath, M Komajda, A Cohen-Solal, J.C Aguilar, R Dietz, A Gavazzi, R Hobbs, J Korewicki, et al. The EuroHeart Failure survey programme--a survey on the quality of care among patients with heart failure in Europe: Part 1: patient characteristics and diagnosis Eur. Heart J., March 1, 2003; 24(5): 442 - 463. [Abstract] [Full Text] [PDF]
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M. Bartnik, K. Malmberg, and L. Ryden Diabetes and the heart: compromised myocardial function -- a common challenge Eur. Heart J. Suppl., January 1, 2003; 5(suppl_B): B33 - B41. [Abstract] [PDF]
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M.R. Cowie The fine art of prognostication Eur. Heart J., December 1, 2002; 23(23): 1804 - 1806. [Full Text] [PDF]
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J. Muntwyler, G. Abetel, C. Gruner, and F. Follath One-year mortality among unselected outpatients with heart failure Eur. Heart J., December 1, 2002; 23(23): 1861 - 1866. [Abstract] [Full Text] [PDF]
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J G F Cleland Contemporary management of heart failure in clinical practice Heart, October 1, 2002; 88(90002): ii5 - 8. [Full Text] [PDF]
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A Varela-Roman, J R Gonzalez-Juanatey, P Basante, R Trillo, J Garcia-Seara, J L Martinez-Sande, and F Gude Clinical characteristics and prognosis of hospitalised inpatients with heart failure and preserved or reduced left ventricular ejection fraction Heart, September 1, 2002; 88(3): 249 - 254. [Abstract] [Full Text] [PDF]
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 S. Kenchaiah, J. C. Evans, D. Levy, P. W.F. Wilson, E. J. Benjamin, M. G. Larson, W. B. Kannel, and R. S. Vasan Obesity and the Risk of Heart Failure N. Engl. J. Med., August 1, 2002; 347(5): 305 - 313. [Abstract] [Full Text] [PDF]
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T. Jaarsma Broadening the real world of health care: what we can do for heart failure patients Eur. Heart J., March 1, 2002; 23(5): 425 - 425. [Full Text] [PDF]
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M.R. Cowie The prognosis of heart failure: the view from the real world Eur. Heart J., August 1, 2001; 22(15): 1247 - 1248. [Abstract] [PDF]
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