Heart Failure on the Rise For U.S. Seniors

The number of seniors, aged 65 and older, who are being admitted into hospitals for the treatment of heart failure has more than doubled in the past three decades. The American Heart Association has estimated that the costs associated with this trend will reach almost $35 billion within the U.S. this year alone.

An estimated 5.3 million Americans suffer from the chronic, potentially fatal, condition of heart failure. Moreover, an additional 660,000 patients are being diagnosed each year. The disease occurs when an enlarged and weakened heart fails to pump enough blood to the body’s organs, leaving them deprived of oxygen. The condition makes the performance of normal daily activities become increasingly more difficult due to mounting fatigue and shortness of breath. Left untreated, the disease can be deadly.

According to a group of U.S. researchers, unless preventive measures are implemented, the number of people who suffer from heart failure will continue to increase at alarming rates. Although hospitalization rates for both stroke and coronary artery disease have steadily declined since 1984, the study found hospitalization rates for heart failure have continued to climb.

As medical technology succeeds in keeping more and more people alive and the baby boomers reach the years beyond the age of 65, the increase in the number of people who suffer from heart failure will become staggering. Researchers say that few therapies can reverse the disease.

Longjian Liu, M.D., Ph.D., M.Sc., associate professor of Epidemiology and Biostatistics of the Drexel University School of Public Health in Philadelphia, Pa, who led the new study stated, “Over the next decades, the number of U.S. adults age 65 and older will double to a projected 70 million, and more than one in five will be 65 or older by the year 2030.” Liu went on to explain, “Because heart failure disproportionately affects the elderly, there is no doubt that the burden of heart failure will increase unless innovative strategies are implemented.”

The study included data from the records of more than 2.2 million seniors, ages 65 or older, who were enrolled in the National Hospital Discharge Surveys between the years 1980 and 2006. When the discharge data was compared with census population data, findings showed the number of these patients who were hospitalized for heart failure rose from 348,866 in 1980 to 807,082 in 2006, an increase of 131 percent.

For women, rates increased from approximately 14 hospitalizations per 1,000 in 1980 to roughly 20 per 1,000 in 2006. For men, the rates rose from about 17 hospitalizations per 1,000 in 1980 to approximately 23 per 1,000 in 2006. Additionally, patients between the ages of 75 and 84 had double the risk of being hospitalized for heart failure than those in the age group of 65 to 74. Those ages 85 and older had quadruple the risk those ages 65 to74.

Liu stressed that the rate increases urgently need to be stopped but cannot be unless innovative strategies are implemented. He stated, “The prevention and treatment of heart failure has become an urgent public health need with national implications. The key is to prevent risk factors for the disease.”

The risk factors for heart failure include high blood pressure, heart attack, stroke, diabetes, obesity as well as lifestyle factors including smoking, lack of exercise and a diet rich in fatty foods. In addition, chronic kidney disease and pneumonia contribute to heart failure stressing the need to focus efforts on the prevention of these conditions as well.

Heart failure is commonly treated with a combination of drugs, including ACE inhibitors or angiotensin receptor inhibitors as these devices dilate arteries and veins and make it easier for the heart to pump blood. In addition, beta-blockers are used to slow the heart rate and to keep control of blood pressure, and diuretics are used to reduce swelling.

Another treatment available for heart failure is Cardiac Resynchronization Therapy (CRT) in which a specialized pacemaker is used to re-coordinate the action of the right and left ventricles in patients with heart failure. These devices help to pace the heart and can effectively shock it back into a proper rhythm, yet less than half of eligible patients in the U.S. have them. Researchers are also studying the use of stem cells to be injected directly into the heart for improved function.

Lui presented the findings of the study at a meeting of the American Heart Association in New Orleans.