Aging Population, Socio-Economic Disparities Linked To Increase in Heart Failure Incidence Interview with:

Prof Kazem Rahimi FRCP The George Institute for Global Health Oxford Martin School University of Oxford, Oxford

Prof. Rahimi

Prof Kazem Rahimi FRCP
The George Institute for Global Health
Oxford Martin School
University of Oxford, Oxford What is the background for this study?

Response: We decided to investigate this topic because disease incidence data is very important for public health bodies; for example, for the allocation of healthcare resources or for the design and assessment of disease prevention measures.

When we reviewed the literature, we found that estimates of heart failure incidence, temporal trends, and association by patient features were scarce. Studies often referred to restricted populations (such as relatively small cohorts that may or may not be representative of the general population), or limited data sources (for example, only including patients hospitalized for their heart failure and not considering those diagnosed by clinicians outside of hospitals). Few studies reported comparable, age-standardized rates, with the result that the rates reported varied considerably across the literature. What are the main findings?

Response: Our study provides evidence that the burden of heart failure in the United Kingdom is increasing, due to population growth and ageing patterns that are also observed in many other high-income countries. We found that each year, heart failure affects as many new patients as breast, prostate, lung and bowel cancer together.

We also found significant socio-economic disparities. People from the most deprived group are about 60% more likely to develop heart failure than those from the most affluent group, and are also more likely to be affected at a younger age.

Finally, our findings highlight important changes in the profile of patients with heart failure; overall, patients are now slightly older when they develop heart failure than they were 12 years ago, and present with a substantially higher number of other chronic conditions. What should readers take away from your report?

Response: The rising incidence of heart failure requires reinforced public health action in terms of prevention and resource planning, as well as efficient and effective care delivery.

Improvements in the prevention of heart failure have been modest compared to gains made with other cardiovascular conditions. We believe the striking socio-economic disparities in the incidence of the condition observed within the same country highlight the – at least partly – preventable nature of heart failure, and the need for more targeted prevention strategies. What recommendations do you have for future research as a result of this study?

Response: We believe our study provides important evidence for policy makers concerned with addressing heart failure in developed countries, and suggest efforts should be focused on the following areas:

  • Research into the determinants of heart failure incidence; in particular, investigation of the reasons for sex, socio-economic and geographic disparities in heart failure incidence rates.
  • Prevention strategies to address inequalities; for example, by concentrating prevention efforts in the most deprived areas.
  • Resource allocation that plans for the increasing number of cases of heart failure; for example, extending the availability of natriuretic peptides testing in the community to ease the burden on echocardiography services.
  • Care-delivery models that are scalable, adaptive, and multidisciplinary, to address the increasing, diverse and largely co-morbid patient population. These could take many forms, such as the implementation of IT-supported home monitoring programmes. Thank you for your contribution to the community.


Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals
Conrad, Nathalie et al.
The Lancet , Volume 0 , Issue 0 ,
Published: 21 November 2017

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on November 26, 2017 by Marie Benz MD FAAD