The burden of heart failure

Chronic heart failure (CHF) places a heavy burden not only on patients and their families but also on society, through enormous use of health care resources. CHF has an overall population prevalence of approximately 1–3%, rising to approximately 10% in the very elderly. Following a first hospital admission for heart failure, patients have a 5-year mortality of 75% — a survival rate worse than that for most forms of cancer. CHF impairs quality of life more than almost any other chronic medical problem. Hospital admissions for CHF have increased markedly over the past two decades. CHF accounts for about 5% of all medical admissions and approximately 2% of total health care expenditure. Despite improvements in medical management, under-treatment is common. Because of the increase in survival after acute myocardial infarction and ageing of the population, the number of patients with CHF will increase rapidly in most industrialized countries. CHF will still pose one of the greatest health care challenges of the 21 st century.