Over the last two decades, the occurrence of heart failure has remained stable but survival has improved considerably - although not uniformly across different demographic groups.

These are the main findings from a population-based study involving 4,537 residents of Olmsted County, Minnesota who were diagnosed with heart failure between 1979 and 2000.

In this large geographically defined community, “we saw no increase in the occurrence of new cases of heart failure pro-rated to the population,” Dr. Veronique L. Roger from the Mayo Clinic in Rochester, Minnesota, told Reuters Health.

“Heart failure has been referred to as an epidemic,” Roger said, “and every time you use the word epidemic this prompts the question of what is causing it - is it because there is more disease or is it because more people are surviving and living with the disease?”

It does not look like the epidemic “is coming from an increase in the rate of the disease,” she said.

According to a report in the July 21st issue of the Journal of the American Medical Association, the incidence of heart failure among men and women in the study was 378 and 289 cases per 100,000 people, respectively, and did not change over time.

After an average of 4 years, 3,347 deaths due to heart failure occurred - 1,930 among women, 1,417 among men; 1,127 among people younger than 75, and 2,220 among those older than 75.

After the onset of heart failure, death rates were a third higher among men than among women. Overall, however, survival improved with time. During the period 1979-1984, 43 percent of heart failure patients survived for 5 years; this increased to 52 percent in 1996-2000.

Men and younger people saw greater gains in survival while there was “less or no improvement” for women and the elderly.

Summing up, Roger said, “People are surviving heart failure longer. Over the years, a number of very effective medications have come on the market to treat heart failure and it is intuitive to believe that this has something to do with the increased survival,” she said, although that was not the focus of the current study.

SOURCE: Journal of the American Medical Association, July 21, 2004.