Heart failure in the general population and impact of the 2021 European Society of Cardiology Heart Failure Guidelines
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Heart failure in the general population and impact of the 2021 European Society of Cardiology Heart Failure Guidelines. / Wenzel, Jan-Per; Nikorowitsch, Julius; Bei der Kellen, Ramona; Magnussen, Christina; Bonin-Schnabel, Renate; Westermann, Dirk; Twerenbold, Raphael; Kirchhof, Paulus; Blankenberg, Stefan; Schrage, Benedikt.
In: ESC HEART FAIL, Vol. 9, No. 4, 08.2022, p. 2157-2169.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Heart failure in the general population and impact of the 2021 European Society of Cardiology Heart Failure Guidelines
AU - Wenzel, Jan-Per
AU - Nikorowitsch, Julius
AU - Bei der Kellen, Ramona
AU - Magnussen, Christina
AU - Bonin-Schnabel, Renate
AU - Westermann, Dirk
AU - Twerenbold, Raphael
AU - Kirchhof, Paulus
AU - Blankenberg, Stefan
AU - Schrage, Benedikt
N1 - © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
PY - 2022/8
Y1 - 2022/8
N2 - 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.
AB - 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.
KW - Cardiology
KW - Female
KW - Heart Failure/diagnosis
KW - Humans
KW - Male
KW - Prognosis
KW - Stroke Volume
KW - Ventricular Function, Left
U2 - 10.1002/ehf2.13948
DO - 10.1002/ehf2.13948
M3 - SCORING: Journal article
C2 - 35445582
VL - 9
SP - 2157
EP - 2169
JO - ESC HEART FAIL
JF - ESC HEART FAIL
SN - 2055-5822
IS - 4
ER -