Læknablaðið - 01.10.2017, Side 36

436 LÆKNAblaðið 2017/103
R A N N S Ó K N
ENGLISH SUMMARY
Introduction: Heart failure (HF) is a common and a serious condition
that predominantly affects elderly people. On the basis of the left
ventricular ejection fraction (EF) it can be divided into HF with reduced or
preserved ejection fraction (HFrEF and HFpEF, respectively). The goal of
this study was to investigate the prevalence and incidence of HF among
elderly Icelanders, explore underlying diseases and estimate the effect
of HF on overall survival.
Material and methods: Included were 5706 participants of the AGES
study. The hospital records of those diagnosed with HF before entry
into AGES were used to calculate prevalence and the records of those
diagnosed from entry into AGES until 28.2.2010 were used to calculate
incidence. All cases of HF were verified according to predetermined
criteria for diagnosis. Information on underlying diseases and EF of HF
patients were obtained from hospital records. Survival was estimated
using Kaplan-Meier survival curves.
Results: Lifetime prevalence of HF was 3.6% as of 2004, higher among
men than women (p<0,001). The incidence was 16.2 cases per 1000
person-years, higher among men than among women (p<0,001). The
incidence of HFrEF was 6.1 per 1000 person-years also higher among
men than women (p<0,001). The incidence of HFpEF was 6.8 per 1000
person-years and there was no statistical difference between the sexes
(p=0.62). The age adjusted 5-year survival rate of HF-patients was
32.5%, there was no statistical difference in relative survival between
men and women (p=0.46). There was no statistical difference between
the survival of patients with HFrEF and those with HFpEF (p=0.52).
Conclusion: Both prevalence and incidence of HF are high among eld-
erly Icelanders, increasing sharply with age and 5-year survival rate is
only around 30%. While men are more likely to develop HF, especially
HFrEF, women are more likely to be diagnosed with HFpEF.
Heart failure among elderly Icelanders: Incidence, prevalence, underlying diseases and long-term survival
Haukur Einarsson1, Guðmundur Þorgeirsson1,2,3, Ragnar Danielsen1,2 , Örn Ólafsson3, Thor Aspelund1,3, Vilmundur Guðnason1,3
1University of Iceland Medicine, 2Landspítali University Hospital, 3Icelandic Heart Association
Keywords: heart failure, HFrEF, HFpEF og AGES-Reykjavik Study.
Correspondence: Haukur Einarsson haukure77@gmail.com
Heimildir
1. Borlaug BA, Redfield MM. Diastolic and systolic heart
failure are distinct phenotypes within the heart failure
spectrum. Circulation 2011;123:2006-13; discussion 14.
2. Bui AL, Horwich TB, Fonarow GC. Epidemiology and
risk profile of heart failure. Nature reviews Cardiology
2011;8:30-41.
3. Senni M, Tribouilloy CM, Rodeheffer RJ, Jacobsen SJ,
Evans JM, Bailey KR, et al. Congestive heart failure in the
community: trends in incidence and survival in a 10-year
period. Archives of internal medicine 1999;159:29-34.
4. Levy D, Kenchaiah S, Larson MG, Benjamin EJ, Kupka
MJ, Ho KK, et al. Long-term trends in the incidence of and
survival with heart failure. The New England journal of
medicine 2002;347:1397-402.
5. Wilhelmsen L, Rosengren A, Eriksson H, Lappas G. Heart
failure in the general population of men--morbidity,
risk factors and prognosis. Journal of internal medicine
2001;249:253-61.
6. Krum H, Abraham WT. Heart failure. Lancet 2009;373:941-
55.
7. Brouwers FP, de Boer RA, van der Harst P, Voors AA,
Gansevoort RT, Bakker SJ, et al. Incidence and epidem-
iology of new onset heart failure with preserved vs.
reduced ejection fraction in a community-based cohort:
11-year follow-up of PREVEND. European heart journal
2013;34:1424-31.
8. Udelson JE. Heart failure with preserved ejection fraction.
Circulation 2011;124:e540-3.
9. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Jr.,
Drazner MH, et al. 2013 ACCF/AHA guideline for the
management of heart failure: a report of the American
College of Cardiology Foundation/American Heart
Association Task Force on Practice Guidelines. Journal of
the American College of Cardiology 2013;62:e147-239.
10. Zarrinkoub R, Wettermark B, Wandell P, Mejhert M,
Szulkin R, Ljunggren G, et al. The epidemiology of
heart failure, based on data for 2.1 million inhabitants in
Sweden. European journal of heart failure 2013;15:995-
1002.
11. Mosterd A, Hoes AW, de Bruyne MC, Deckers JW, Linker
DT, Hofman A, et al. Prevalence of heart failure and left
ventricular dysfunction in the general population; The
Rotterdam Study. European heart journal 1999;20:447-55.
12. Mehta PA, Cowie MR. Gender and heart failure: a
population perspective. Heart 2006;92 Suppl 3:iii14-8.
13. Stromberg A, Martensson J. Gender differences in patients
with heart failure. European journal of cardiovascular
nursing : journal of the Working Group on Cardiovascular
Nursing of the European Society of Cardiology 2003;2:7-
18.
14. Owan TE, Redfield MM. Epidemiology of diastolic heart
failure. Progress in cardiovascular diseases 2005;47:320-
32.
15. Harris TB, Launer LJ, Eiriksdottir G, Kjartansson O,
Jonsson PV, Sigurdsson G, et al. Age, Gene/Environment
Susceptibility-Reykjavik Study: multidisciplinary app-
lied phenomics. American journal of epidemiology
2007;165:1076-87.
16. Danielsen R, Aspelund T, Harris TB, Gudnason V. The
prevalence of aortic stenosis in the elderly in Iceland and
predictions for the coming decades: the AGES-Reykjavik
study. International journal of cardiology 2014;176:916-22.
17. RStudio: Integrated Development for R. RStudio, Inc. 3.1.3
ed. Boston, MA: RStudio Team; 2015.
18. StataCorp. Stata Statistical Software: Release 13. College
Station, TX: StataCorp LP; 2013.
19. Sigbergsdottir A, Sigurdsson AF. Hjartabilun með varð-
veitta slegilvirkni (hlébilsbilun). Samanburður á hlé- og
slagbilsbilun. Læknablaðið 2006;Fylgirit 52 V1.
20. Thrainsdottir IS, Aspelund T, Thorgeirsson G, Gudnason
V, Hardarson T, Malmberg K, et al. The association
between glucose abnormalities and heart failure in
the population-based Reykjavik study. Diabetes care
2005;28:612-6.
21. Mosterd A, Hoes AW. Clinical epidemiology of heart
failure. Heart 2007;93:1137-46.
22. Redfield MM, Jacobsen SJ, Burnett JC, Jr., Mahoney DW,
Bailey KR, Rodeheffer RJ. Burden of systolic and diastolic
ventricular dysfunction in the community: appreciating
the scope of the heart failure epidemic. Jama 2003;289:194-
202.
23. Curtis LH, Whellan DJ, Hammill BG, Hernandez AF,
Anstrom KJ, Shea AM, et al. Incidence and prevalence
of heart failure in elderly persons, 1994-2003. Archives of
internal medicine 2008;168:418-24.
24. Cowie MR, Wood DA, Coats AJ, Thompson SG, Poole-
Wilson PA, Suresh V, et al. Incidence and aetiology of
heart failure; a population-based study. European heart
journal 1999;20:421-8.
25. Gottdiener JS, Arnold AM, Aurigemma GP, Polak JF,
Tracy RP, Kitzman DW, et al. Predictors of congestive
heart failure in the elderly: the Cardiovascular Health
Study. Journal of the American College of Cardiology
2000;35:1628-37.
26. Komamura K. Similarities and Differences between
the Pathogenesis and Pathophysiology of Diastolic and
Systolic Heart Failure. Cardiology research and practice
2013;2013:824135.
27. Loehr LR, Rosamond WD, Chang PP, Folsom AR,
Chambless LE. Heart failure incidence and survival (from
the Atherosclerosis Risk in Communities study). The
American journal of cardiology 2008;101:1016-22.
28. Ho KK, Anderson KM, Kannel WB, Grossman W,
Levy D. Survival after the onset of congestive heart
failure in Framingham Heart Study subjects. Circulation
1993;88:107-15.
29. Simon T, Mary-Krause M, Funck-Brentano C, Jaillon
P. Sex differences in the prognosis of congestive heart
failure: results from the Cardiac Insufficiency Bisoprolol
Study (CIBIS II). Circulation 2001;103:375-80.
30. Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL,
Redfield MM. Trends in prevalence and outcome of heart
failure with preserved ejection fraction. The New England
journal of medicine 2006;355:251-9.
31. Senni M, Redfield MM. Heart failure with preserved
systolic function. A different natural history? Journal of
the American College of Cardiology 2001;38:1277-82.
32. Dunlay SM, Weston SA, Jacobsen SJ, Roger VL. Risk
factors for heart failure: a population-based case-control
study. The American journal of medicine 2009;122:1023-8.