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The prognosis of heart failure in the general population. The Rotterdam Study

A Mosterd, B Cost, A.W Hoes, M.C de Bruijne, J.W Deckers, A Hofman, D.E Grobbee
DOI: http://dx.doi.org/10.1053/euhj.2000.2533 1318-1327 First published online: 1 August 2001


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.

  • Heart failure, epidemiology, diabetes mellitus, prognosis, sudden death, mortality