12.03.1 The Heart Failure Epidemic

Heart failure is one of the most common causes of death and disability.  Congestive Heart Failure (CHF) is when heart failure is accompanied by congestion in the lungs.  The prevalence of Congestive Heart Failure in Australia, as elsewhere increases with age.  In Australia, at 50-59 years of age, 1% of subjects have CHF, after 60 years of age, 13% have CHF, and over 85 years of age, 50% have heart failure.  CHF is deadly, with a mortality rate of 50% at 5 years.  At present, 300,000 Australians have CHF with 30,000 new cases annually.  CHF is also an expensive disease with one-third of hospitalisation in the over 70 years being due to CHF.

Until fairly recently, hypertension and angina led to premature deaths due to heart attacks. However, good pharmacotherapy for hypertension, angina and heart attacks has reduced the deaths from heart attack, and subjects live on to get heart failure.  There is also a general ageing of the population with life expectancy continually increasing in most Westernised countries.  Thus, there is an increased incidence of old people with CHF.

With the reduced cardiac output that is heart failure, there is poor delivery of oxygen and nutrients to the tissues of the body.  In heart failure, there is also reduced removal of carbon dioxide and waste materials from the tissues.