Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Epidemiology of HF in Older Adults Across Settings

Circ Heart Fail; ePub 2017 Nov 12; Khera, et al

Medicare beneficiaries have experienced a decline in incident heart failure (HF) and a decrease in 1-year HF mortality in recent years; however, the overall burden of HF continues to increase. This according to a study that included a cohort of 2,331,939 unique fee-for-service Medicare beneficiaries (mean age 72 years, 57% women, 86% white, 8% black) followed for all inpatient and outpatient encounters over a 10-year period from 2004 to 2013. Within the cohort, 518,223 patients had preexisting HF, and 349,829 had a new diagnosis of HF during the study period. Further details include:

  • The rates of incident HF declined 32%, from 38.7 per 1,000 in 2004 to 26.2 per 1,000 beneficiaries in 2013.
  • In contrast, prevalent HF increased during the study period from 162 per 1,000 in 2004 to 172 per 1,000 beneficiaries in 2013.
  • Overall 1-year mortality among patients with incident HF was elevated at 24.7%, with a 0.4% absolute decline annually, and a more pronounced decrease among those diagnosed in an inpatient vs outpatient setting.

Citation:

Khera R, Pandey A, Ayers CR, et al. Contemporary epidemiology of heart failure in fee-for-service Medicare beneficiaries across healthcare settings. [Published online ahead of print November 12, 2017]. Circ Heart Fail. doi:10.1161/CIRCHEARTFAILURE.117.004402.