ABSTRACT
In recent years it has become increasingly obvious that heart failure (HF) is a modern-day epidemic that deserves special attention to minimize its increasing impact at the population level.1-2 For example, when considering the overall ageing of the essentially stable UK population (about 60 million people) and trends in improved population survival rates associated with previously fatal cardiac events3,4 in addition to contemporary UK-based epidemiologic data,5-8 it is likely that the number of individuals affected by this heterogeneous syndrome will rise by a further 20-25% (with 1.25 million affected) by the year 2020.9 Such a rise follows an even more dramatic increase in its prevalence during the 20-year period 1980-2000.6,10
In addition to becoming more common, HF imposes a considerable financial burden on the health care systems of nearly all developed countries.2,11 Recent data emanating from the UK suggest the proportion of ‘direct’ health care expenditure attributable to HF has almost doubled since 199012 to 2% of the health budget in the year 2000 (when all HF-related hospitalizations are considered this figure approximately doubles).13 Consistent with data from other developed countries,2,14
hospital activity in the UK represents the greatest component (70%) of direct health care expenditure.13 Consistent with these UK data, in the US, HF is the single largest item of expenditure for Medicare and is the most common cause of hospitalization in those aged > 65 years.14,15
While it is easy to deliver a series of statistics to support the notion that HF is an extremely important public health issue, it is (perhaps) more important to highlight the individual burden of HF and the complex issues that clinicians typically face when dealing with the ‘average’ patient.
