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Heart Failure Rising In Older Americans

But more are surviving longer with the disease, report finds

MONDAY, Feb. 6, 2006 (HealthDay News) -- The bad news from a new report on heart failure is that the debilitating condition continues to rise among older Americans.

The good news is that men -- and possibly women -- who are diagnosed with heart failure are living longer now than ever before.

Even though the incidence of heart failure jumped 14 percent between 1970 and 1994, five-year death rates fell at the same time by "a significant 33 percent among men and showed a borderline decrease of 24 percent in women," lead researcher Dr. William H. Barker, professor emeritus of preventive medicine and gerontology at the University of Rochester School of Medicine in New York, said in a statement.

The findings appear in the Feb. 7 issue of Circulation.

Heart failure occurs when the heart cannot pump blood fast enough or efficiently enough to meet the body's needs. In many cases, heart failure involves some kind of residual damage to heart muscle, such as that occurring after a heart attack.

The study was based on long-term data from the Kaiser Permanente Northwest Region HMO involving more than 300,000 people. That data showed the overall incidence of heart failure increased by 14 percent from 1970-74 to 1990-94 for men and women aged 65 and older.

Hospitalizations for heart failure doubled between the two periods, making the condition the most common diagnosis for older Americans discharged from hospitals today, the report said.

"We know that this increase in incidence is in part because the population is aging," said Dr. Alice Jacobs, a professor of medicine at Boston University and immediate past president of the American Heart Association. "The good news is that survival is increasing because our therapies are more effective."

Jacobs took a guarded view of the reported survival difference between men and women. "The gender differences are provocative, but they have to be taken with caution because of the limitations of the study," she said.

Barker speculated that two factors might explain why survival has increased significantly for men but not women: More women than men are in nursing homes, indicating they may suffer from greater physical weakness; and women appear to have more debilitating diseases such as diabetes, cancer and chronic obstructive pulmonary disease.

There is a lesson for older Americans in the report, Jacobs said. "It is important that they know their risk factors for development of heart failure, that they be compliant with all the medications prescribed for them, that they see their physicians regularly and report all symptoms so it can be diagnosed and treated, especially since there are very effective therapies now," she stressed.

Another report in the same issue of the journal signaled the need for better watch over cardiovascular risk factors for people of all ages. The study, the first of its kind, looked at 50,000 50-year-olds and predicted that more than half of all men, and nearly 40 percent of women, in the United States will develop cardiovascular conditions during their lifetimes.

After looking at the known risk factors for cardiovascular disease -- cholesterol, high blood pressure, obesity, diabetes and so on -- the researchers say men whose risk factors were all "optimal" were at a significantly lower risk of facing cardiovascular troubles problems in the years ahead, compared to those with multiple risk factors.

At age 50, the average lifetime risk for developing cardiovascular disease before age 95 is 51.7 percent for men and 39.2 percent for women, the team noted. But it was only 5.2 percent for men with optimal risk factors.

"Given the substantial benefit, we need to do a better job of getting people to reach age 50 with optimal risk factors," said study author Dr. Donald M. Lloyd-Jones, an assistant professor of preventive medicine and medicine at Northwestern University.

That means "more focus on lifestyle, diet and physical activity in younger people," Lloyd-Jones said. "It means maintaining normal weight, avoiding smoking, keeping an eye on blood pressure and on cholesterol."

And if you're not where you should be at age 50, "It's never too late to start," he said. "What these data suggest is the need for aggressive measures, including medication if necessary, to get risk factors under control."

More information

Learn more about heart failure at the American Heart Association.

SOURCES: Alice Jacobs, M.D., professor, Medicine, Boston University; Donald M. Lloyd-Jones, M.D., assistant professor, preventive medicine and medicine, Northwestern University, Chicago; Feb. 7, 2005, Circulation
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