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U.S. Heart Failure Doubles Over 25 Years, Study Finds

Twice as many older Americans are hospitalized with heart failure than 25 years ago, reflecting an aging population and success in keeping people alive after heart attacks and disease damage the organ, researchers said.

The study, reported today at the American Heart Association meeting in New Orleans, found 807,082 people aged 65 and older were hospitalized with heart failure in 2006, a 131 percent increase from 348,866 in 1980. The report is the first to document the relentless expansion of the disease across the U.S.

The numbers can be expected to grow, and add to national health-care costs, as medical technology helps keep more people alive through disease and baby boomers, those born between 1946 and 1964, reach their 70s and 80s. Few therapies can reverse the deadly disease, researchers said.

“The prevention and treatment of heart failure has become an urgent public health need with national implications,” said Longjian Liu, the lead researcher and an associate professor of epidemiology and biostatistics at Drexel University School of Public Health in Philadelphia. “Because heart failure disproportionately affects the elderly, there is no doubt that the burden of heart failure will increase unless innovative strategies are implemented.”

More than 5 million Americans now have heart failure and another 660,000 patients are diagnosed yearly, according to the American Heart Association.
Devices called cardiac cardiac resynchronization therapy, which help pace the heart and can shock it back into a proper rhythm, are effective, though studies show fewer than half of eligible patients in the U.S. receive them. Researchers are also investigating the use of stem cells, injected directly into the heart, to improve its function, with mixed results.

The study found the risk for heart failure among women is growing faster than in men, though men are still more likely to wind up in the hospital each year. The risk also increased with age, as patients aged 75 to 85 were twice as likely to wind up in the hospital as younger people.

“Frankly, people are living longer,” said Vincent Bufalino, clinical associate professor of medicine at Loyola University Stritch School of Medicine in Chicago. “Whether you like it or not, they are developing progressive disease.”

The best approach to reducing hospitalization is to prevent heart failure from developing in the first place, Liu said in a statement. Risk factors for heart disease include high blood pressure, heart and lung disease, diabetes, stroke and obesity.

Heart transplants, devices to help the heart function, valve surgery and hypertension drugs are also keeping heart failure patients alive longer now than they did a decade ago, helping boost the number of patients, Bufalino said. That’s translating into higher costs for Medicare, the government’s health insurance program for the elderly, he said.

“Our problem is this is 14 percent of the Medicare population and 42 percent of the resources,” he said. “That’s our dilemma. With the present set of resources, this elderly population that we’re taking care of that we didn’t take care of before, plus the baby boomers, is a double demographic. We will not have the resources to care for them.”

Reported at American Heart Association meeting Nov 2008