Incidence, prevalence, and mortality of heart failure: a nationwide registry study from 2013 to 2016

• Published in: ESC Heart Failure 2020-08, Vol.7 (4), p.1917-1926
• Main Authors: Ødegaard, Kristina Malene, Hallén, Jonas, Lirhus, Sandre Svatun, Melberg, Hans Olav, Halvorsen, Sigrun
• Format: Article
• Language: English
• Subjects: Age; Calendars; Cardiac arrhythmia; Cardiovascular disease; Chronic obstructive pulmonary disease; Codes; Diabetes; Drug stores; Epidemiology; Gender; Heart attacks; Heart failure; Hypertension; Incidence; Medical prognosis; Morbidity; Mortality; NorPD; Original; Original s; Patients; Personal identification numbers; Pharmacy; Prescription drugs; Prevalence; Standard deviation; Statistical analysis
• ISSN: 2055-5822; 2055-5822
• DOI: 10.1002/ehf2.12773

Aims Large‐scaled population studies of incidence and prevalence of heart failure (HF) are needed for the development of healthcare policies and priorities. The aim of this study was to estimate the incidence, prevalence, and all‐cause mortality of HF in Norway from 2013 to 2016 on the basis of a national registry. Methods and results Using data from the nationwide Norwegian Prescription Database, we identified all patients ≥18 years of age in Norway with at least one drug prescription with HF during 2013–2016, defined by 10th revision of the International Classification of Diseases (ICD‐10) codes I50, I11, I13, or I42. The individual index date was the date of the first prescription. Patients were followed up until death or end of follow‐up (31 October 2017). Annual incidence and prevalence were estimated from 2013 to 2016, using a look‐back period starting from 1 March 2008. We calculated standardized estimates by applying direct age and sex standardization to the 2013 European standard population. All‐cause mortality from 2013 to 2016 was calculated among the prevalent HF patients. Standardized mortality ratio (SMR) was calculated by indirect standardization using general mortality in the Norwegian population as reference. We identified 54 542 unique patients (58% men) with a first‐time diagnosis of HF. The median age was 72 ±14 years, and women were older than men (median age 76 vs. 70 years, respectively). The crude (standardized) incidence of HF was 3.44/1000 (4.23/1000) person‐years in 2016 and did not increase over the 4 year period, while the prevalence increased from 2.0% (2.3%) to 2.4% (2.8%). Both incidence and prevalence were higher in men than in women and strongly associated with age. Crude mortality rates in the HF population declined from 94 to 82/1000 person‐years from 2013 to 2016, and SMR declined from 2.01 to 1.84. Age‐adjusted mortality rates were higher in men than in women. Conclusions This nationwide registry study in Norway showed an increase in the prevalence of HF from 2013 to 2016, with stable incidence rates and improved survival.