The prognosis of heart failure in the general population. The Rotterdam Study

• Published in: European heart journal 2001-08, Vol.22 (15), p.1318-1327
• Main Authors: Mosterd, A, Cost, B, Hoes, A.W, de Bruijne, M.C, Deckers, J.W, Hofman, A, Grobbee, D.E
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Death, Sudden, Cardiac - etiology; diabetes mellitus; epidemiology; Female; Follow-Up Studies; Heart failure; Heart Failure - complications; Heart Failure - epidemiology; Heart Failure - mortality; Humans; Male; Middle Aged; mortality; Netherlands - epidemiology; Prevalence; Prognosis; Regression Analysis; Risk Factors; sudden death; Survival Analysis
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1053/euhj.2000.2533

Aims To determine the prognosis, cause of death, and its determinants in participants of the population-based Rotterdam Study who were found to have heart failure. Methods and Results In 5255 Rotterdam Study participants (aged 68·9±8·6 years, 3113 women) the presence of heart failure was determined. Data were analysed with Cox's proportional-hazards models. One hundred and eighty-one participants (age 77·3±7·9 years, 109 women) had heart failure. Of these 85 (47%) died during the 4·8–8·5 (mean 6·1) years of follow-up. One, 2 and 5 years' survival was 89%, 79%, and 59%, representing an age-adjusted mortality twice that of persons without heart failure (hazard ratio 2·1, 95% CI 1·8–2·7). The hazard ratio for sudden death was even more pronounced: 4·8, (95% CI 2·6–8·7). Diabetes mellitus, impairment of renal function and atrial fibrillation were associated with a poor outcome. A higher blood pressure and body mass index conferred a more favourable prognosis in those with heart failure. Conclusion Heart failure generally afflicts older subjects in the community, carries a poor prognosis, especially in the presence of concomitant diseases, and confers a fivefold increase in the risk of sudden death.