Heart failure in the general population and impact of the 2021 European Society of Cardiology Heart Failure Guidelines
Abstract Aim The diagnosis of heart failure (HF) has been refined in several steps in recent years, reflecting evolving diagnostic and therapeutic approaches. The European Society of Cardiology (ESC) recently published a modified definition of HF in the 2021 heart failure (HF) guidelines. The impact...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-08-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.13948 |
| _version_ | 1828756710282493952 |
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| author | Jan‐Per Wenzel Julius Nikorowitsch Ramona bei derKellen Christina Magnussen Renate Bonin‐Schnabel Dirk Westermann Raphael Twerenbold Paulus Kirchhof Stefan Blankenberg Benedikt Schrage |
| author_facet | Jan‐Per Wenzel Julius Nikorowitsch Ramona bei derKellen Christina Magnussen Renate Bonin‐Schnabel Dirk Westermann Raphael Twerenbold Paulus Kirchhof Stefan Blankenberg Benedikt Schrage |
| author_sort | Jan‐Per Wenzel |
| collection | DOAJ |
| description | Abstract Aim The diagnosis of heart failure (HF) has been refined in several steps in recent years, reflecting evolving diagnostic and therapeutic approaches. The European Society of Cardiology (ESC) recently published a modified definition of HF in the 2021 heart failure (HF) guidelines. The impact of this new diagnostic algorithm on the prevalence of HF is not known. The aim of this study was to describe the contemporary prevalence of HF in a representative, completely phenotyped sample from the general population. Methods and results This analysis was conducted among 7074 participants (aged 45–78 years, 51.5% women) from the population‐based Hamburg City Health Study. Compared with the 2016 version, HF prevalence increased with the 2021 HF guidelines from 4.31% to 4.83% (12% increase). This increase was driven by a higher number of subjects with HF with reduced/mildly‐reduced ejection fraction (0.47% to 0.52%; 1.37% to 2.12%), while the number of subjects with HF with preserved ejection fraction decreased from 2.46% to 2.19%. Importantly, this did not impact the known risk factor profiles of the phenotypes. Although four drugs are recommended for all subjects with HFrEF in the new guidelines, several adjunctive therapies are recommended for dedicated cases/scenarios (e.g. <1% eligibility for ivabradine/vericiguat/devices). Conclusion Heart failure remains common in a contemporary general population sample. The number of patients with HF will increase when the current diagnostic criteria are applied. This offers opportunities to initiate preventive therapies, especially in patients with HFmrEF and HFrEF. |
| first_indexed | 2024-12-10T23:20:37Z |
| format | Article |
| id | doaj.art-14557db9ef154c46acb91833245c9dd6 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-10T23:20:37Z |
| publishDate | 2022-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-14557db9ef154c46acb91833245c9dd62022-12-22T01:29:43ZengWileyESC Heart Failure2055-58222022-08-01942157216910.1002/ehf2.13948Heart failure in the general population and impact of the 2021 European Society of Cardiology Heart Failure GuidelinesJan‐Per Wenzel0Julius Nikorowitsch1Ramona bei derKellen2Christina Magnussen3Renate Bonin‐Schnabel4Dirk Westermann5Raphael Twerenbold6Paulus Kirchhof7Stefan Blankenberg8Benedikt Schrage9Department of Cardiology University Heart and Vascular Centre Hamburg Hamburg GermanyDepartment of Cardiology University Heart and Vascular Centre Hamburg Hamburg GermanyEpidemiological Study Centre Hamburg GermanyDepartment of Cardiology University Heart and Vascular Centre Hamburg Hamburg GermanyDepartment of Cardiology University Heart and Vascular Centre Hamburg Hamburg GermanyDepartment of Cardiology University Heart and Vascular Centre Hamburg Hamburg GermanyDepartment of Cardiology University Heart and Vascular Centre Hamburg Hamburg GermanyDepartment of Cardiology University Heart and Vascular Centre Hamburg Hamburg GermanyDepartment of Cardiology University Heart and Vascular Centre Hamburg Hamburg GermanyDepartment of Cardiology University Heart and Vascular Centre Hamburg Hamburg GermanyAbstract Aim The diagnosis of heart failure (HF) has been refined in several steps in recent years, reflecting evolving diagnostic and therapeutic approaches. The European Society of Cardiology (ESC) recently published a modified definition of HF in the 2021 heart failure (HF) guidelines. The impact of this new diagnostic algorithm on the prevalence of HF is not known. The aim of this study was to describe the contemporary prevalence of HF in a representative, completely phenotyped sample from the general population. Methods and results This analysis was conducted among 7074 participants (aged 45–78 years, 51.5% women) from the population‐based Hamburg City Health Study. Compared with the 2016 version, HF prevalence increased with the 2021 HF guidelines from 4.31% to 4.83% (12% increase). This increase was driven by a higher number of subjects with HF with reduced/mildly‐reduced ejection fraction (0.47% to 0.52%; 1.37% to 2.12%), while the number of subjects with HF with preserved ejection fraction decreased from 2.46% to 2.19%. Importantly, this did not impact the known risk factor profiles of the phenotypes. Although four drugs are recommended for all subjects with HFrEF in the new guidelines, several adjunctive therapies are recommended for dedicated cases/scenarios (e.g. <1% eligibility for ivabradine/vericiguat/devices). Conclusion Heart failure remains common in a contemporary general population sample. The number of patients with HF will increase when the current diagnostic criteria are applied. This offers opportunities to initiate preventive therapies, especially in patients with HFmrEF and HFrEF.https://doi.org/10.1002/ehf2.139482016 ESC heart failure guidelines2021 ESC heart failure guidelinesHFpEFHFrEFDiagnosis |
| spellingShingle | Jan‐Per Wenzel Julius Nikorowitsch Ramona bei derKellen Christina Magnussen Renate Bonin‐Schnabel Dirk Westermann Raphael Twerenbold Paulus Kirchhof Stefan Blankenberg Benedikt Schrage Heart failure in the general population and impact of the 2021 European Society of Cardiology Heart Failure Guidelines ESC Heart Failure 2016 ESC heart failure guidelines 2021 ESC heart failure guidelines HFpEF HFrEF Diagnosis |
| title | Heart failure in the general population and impact of the 2021 European Society of Cardiology Heart Failure Guidelines |
| title_full | Heart failure in the general population and impact of the 2021 European Society of Cardiology Heart Failure Guidelines |
| title_fullStr | Heart failure in the general population and impact of the 2021 European Society of Cardiology Heart Failure Guidelines |
| title_full_unstemmed | Heart failure in the general population and impact of the 2021 European Society of Cardiology Heart Failure Guidelines |
| title_short | Heart failure in the general population and impact of the 2021 European Society of Cardiology Heart Failure Guidelines |
| title_sort | heart failure in the general population and impact of the 2021 european society of cardiology heart failure guidelines |
| topic | 2016 ESC heart failure guidelines 2021 ESC heart failure guidelines HFpEF HFrEF Diagnosis |
| url | https://doi.org/10.1002/ehf2.13948 |
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