Skip to main content
Top
Published in: BMC Health Services Research 1/2016

Open Access 01-12-2016 | Research article

Current and projected burden of heart failure in the Australian adult population: a substantive but still ill-defined major health issue

Authors: Yih-Kai Chan, Camilla Tuttle, Jocasta Ball, Tiew-Hwa Katherine Teng, Yasmin Ahamed, Melinda Jane Carrington, Simon Stewart

Published in: BMC Health Services Research | Issue 1/2016

Login to get access

Abstract

Background

Comprehensive epidemiological data to describe the burden of heart failure (HF) in Australia remain lacking despite its importance as a major health issue. Herewith, we estimate the current and future burden of HF in Australia using best available data.

Methods

Australian-specific and the most congruent international epidemiological and health utilisation data were applied to the Australian population (adults aged ≥ 45 years, 8.9 of 22.7 million total population in 2014) on an age and sex-specific basis. We estimated the current incident and prevalent cases of clinically overt/symptomatic HF (predominately those with reduced ejection fraction), hospital activity (diagnosis of HF as a primary or secondary reason for admission) and health care costs in 2014 and future prevalence and burden of HF projected to 2030.

Results

We estimated that over 61,000 (6.9 per 1000 person-years) adult Australians aged ≥ 45 years (58 % women) are diagnosed with HF with clinically overt signs and symptoms every year. On a conservative basis, 480,000 (6.3 %, 95 % CI 2.6 to 10.0 %) Australians (66 % men) are now affected by the syndrome with > 150,000 hospitalisations in excess of 1 million days in hospital per annum. The annual cost of managing HF in the community is approximately $900 million and nearly $2.7 billion ($1.5 versus $1.2 billion, men versus women) when considering the additional cost of in-patient care. We predict that the prevalence and future burden of HF will continue to increase over the next 10–15 years to nearly 750,000 people with an estimated annual health care cost of $3.8 billion.

Conclusions

Australia is not immune to the growing magnitude and implications of a sustained epidemic of HF in an ageing population. However, its public health and economic burden will remain ill-defined until more definitive Australian-specific data are generated.
Literature
1.
go back to reference Khatibzadeh S, Farzadfar F, Oliver J, Ezzati M, Moran A. Worldwide risk factors for heart failure: a systematic review and pooled analysis. Int J Cardiol. 2013;168(2):1186–94.CrossRefPubMed Khatibzadeh S, Farzadfar F, Oliver J, Ezzati M, Moran A. Worldwide risk factors for heart failure: a systematic review and pooled analysis. Int J Cardiol. 2013;168(2):1186–94.CrossRefPubMed
2.
go back to reference Clark RA, McLennan S, Dawson A, Wilkinson D, Stewart S. Uncovering a hidden epidemic: a study of the current burden of heart failure in Australia. Heart Lung Circ. 2004;13(3):266–73.CrossRefPubMed Clark RA, McLennan S, Dawson A, Wilkinson D, Stewart S. Uncovering a hidden epidemic: a study of the current burden of heart failure in Australia. Heart Lung Circ. 2004;13(3):266–73.CrossRefPubMed
3.
go back to reference Levy D, Larson MG, Vasan RS, Kannel WB, Ho KK. The progression from hypertension to congestive heart failure. JAMA. 1996;275(20):1557–62.CrossRefPubMed Levy D, Larson MG, Vasan RS, Kannel WB, Ho KK. The progression from hypertension to congestive heart failure. JAMA. 1996;275(20):1557–62.CrossRefPubMed
4.
go back to reference Carrington MJ, Jennings GL, Stewart S. Pressure points in primary care: blood pressure and management of hypertension in 532 050 patients from 2005 to 2010. J Hypertens. 2013;31(6):1265–71.CrossRefPubMed Carrington MJ, Jennings GL, Stewart S. Pressure points in primary care: blood pressure and management of hypertension in 532 050 patients from 2005 to 2010. J Hypertens. 2013;31(6):1265–71.CrossRefPubMed
5.
go back to reference Paulus WJ, Tschope C, Sanderson JE, Rusconi C, Flachskampf FA, Rademakers FE, et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J. 2007;28(20):2539–50.CrossRefPubMed Paulus WJ, Tschope C, Sanderson JE, Rusconi C, Flachskampf FA, Rademakers FE, et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J. 2007;28(20):2539–50.CrossRefPubMed
6.
go back to reference Krum H, Jelinek MV, Stewart S, Sindone A, Atherton JJ. National Heart Foundation of Australia, et al. 2011 update to National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand Guidelines for the prevention, detection and management of chronic heart failure in Australia, 2006. Med J Aust. 2011;194(8):405–9.PubMed Krum H, Jelinek MV, Stewart S, Sindone A, Atherton JJ. National Heart Foundation of Australia, et al. 2011 update to National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand Guidelines for the prevention, detection and management of chronic heart failure in Australia, 2006. Med J Aust. 2011;194(8):405–9.PubMed
7.
go back to reference McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2012;14(8):803–69.CrossRefPubMed McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2012;14(8):803–69.CrossRefPubMed
8.
go back to reference Abhayaratna WP, Smith WT, Becker NG, Marwick TH, Jeffery IM, McGill DA. Prevalence of heart failure and systolic ventricular dysfunction in older Australians: the Canberra Heart Study. Med J Aust. 2006;184(4):151–4.PubMed Abhayaratna WP, Smith WT, Becker NG, Marwick TH, Jeffery IM, McGill DA. Prevalence of heart failure and systolic ventricular dysfunction in older Australians: the Canberra Heart Study. Med J Aust. 2006;184(4):151–4.PubMed
9.
go back to reference Teng TH, Finn J, Hobbs M, Hung J. Heart failure: incidence, case fatality, and hospitalization rates in Western Australia between 1990 and 2005. Circ Heart Fail. 2010;3(2):236–43.CrossRefPubMed Teng TH, Finn J, Hobbs M, Hung J. Heart failure: incidence, case fatality, and hospitalization rates in Western Australia between 1990 and 2005. Circ Heart Fail. 2010;3(2):236–43.CrossRefPubMed
12.
go back to reference World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.CrossRef World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.CrossRef
13.
go back to reference Stewart S, MacIntyre K, Capewell S, McMurray JJ. Heart failure and the aging population: an increasing burden in the 21st century? Heart. 2003;89(1):49–53.CrossRefPubMedPubMedCentral Stewart S, MacIntyre K, Capewell S, McMurray JJ. Heart failure and the aging population: an increasing burden in the 21st century? Heart. 2003;89(1):49–53.CrossRefPubMedPubMedCentral
14.
go back to reference Robertson J, McElduff P, Pearson SA, Henry DA, Inder KJ, Attia JR. The health services burden of heart failure: an analysis using linked population health data-sets. BMC Health Serv Res. 2012;12:103.CrossRefPubMedPubMedCentral Robertson J, McElduff P, Pearson SA, Henry DA, Inder KJ, Attia JR. The health services burden of heart failure: an analysis using linked population health data-sets. BMC Health Serv Res. 2012;12:103.CrossRefPubMedPubMedCentral
15.
go back to reference Cowie MR, Wood DA, Coats AJ, Thompson SG, Poole-Wilson PA, Suresh V, et al. Incidence and aetiology of heart failure; a population-based study. Eur Heart J. 1999;20(6):421–8.CrossRefPubMed Cowie MR, Wood DA, Coats AJ, Thompson SG, Poole-Wilson PA, Suresh V, et al. Incidence and aetiology of heart failure; a population-based study. Eur Heart J. 1999;20(6):421–8.CrossRefPubMed
16.
go back to reference Bleumink GS, Knetsch AM, Sturkenboom MC, Straus SM, Hofman A, Deckers JW, et al. Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure The Rotterdam Study. Eur Heart J. 2004;25(18):1614–9.CrossRefPubMed Bleumink GS, Knetsch AM, Sturkenboom MC, Straus SM, Hofman A, Deckers JW, et al. Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure The Rotterdam Study. Eur Heart J. 2004;25(18):1614–9.CrossRefPubMed
17.
go back to reference Senni M, Tribouilloy CM, Rodeheffer RJ, Jacobsen SJ, Evans JM, Bailey KR, et al. Congestive heart failure in the community: a study of all incident cases in Olmsted County, Minnesota, in 1991. Circulation. 1998;98(21):2282–9.CrossRefPubMed Senni M, Tribouilloy CM, Rodeheffer RJ, Jacobsen SJ, Evans JM, Bailey KR, et al. Congestive heart failure in the community: a study of all incident cases in Olmsted County, Minnesota, in 1991. Circulation. 1998;98(21):2282–9.CrossRefPubMed
18.
go back to reference Stewart S, Carrington MJ, Marwick TH, Davidson PM, Macdonald P, Horowitz JD, et al. Impact of home versus clinic-based management of chronic heart failure: the WHICH? (Which Heart Failure Intervention Is Most Cost-Effective & Consumer Friendly in Reducing Hospital Care) Multicenter, Randomized Trial. J Am Coll Cardiol. 2012;60(14):1239–48.CrossRefPubMed Stewart S, Carrington MJ, Marwick TH, Davidson PM, Macdonald P, Horowitz JD, et al. Impact of home versus clinic-based management of chronic heart failure: the WHICH? (Which Heart Failure Intervention Is Most Cost-Effective & Consumer Friendly in Reducing Hospital Care) Multicenter, Randomized Trial. J Am Coll Cardiol. 2012;60(14):1239–48.CrossRefPubMed
19.
go back to reference Shah SJ. Matchmaking for the optimization of clinical trials of heart failure with preserved ejection fraction: no laughing matter. J Am Coll Cardiol. 2013;62(15):1339–42.CrossRefPubMed Shah SJ. Matchmaking for the optimization of clinical trials of heart failure with preserved ejection fraction: no laughing matter. J Am Coll Cardiol. 2013;62(15):1339–42.CrossRefPubMed
20.
go back to reference Oktay AA, Rich JD, Shah SJ. The emerging epidemic of heart failure with preserved ejection fraction. Curr Heart Fail Rep. 2013;10(4):401–10.CrossRefPubMed Oktay AA, Rich JD, Shah SJ. The emerging epidemic of heart failure with preserved ejection fraction. Curr Heart Fail Rep. 2013;10(4):401–10.CrossRefPubMed
21.
go back to reference Moran AE, Forouzanfar MH, Roth GA, Mensah GA, Ezzati M, Murray CJ, et al. Temporal trends in ischemic heart disease mortality in 21 world regions, 1980 to 2010: the Global Burden of Disease 2010 study. Circulation. 2014;129(14):1483–92.CrossRefPubMedPubMedCentral Moran AE, Forouzanfar MH, Roth GA, Mensah GA, Ezzati M, Murray CJ, et al. Temporal trends in ischemic heart disease mortality in 21 world regions, 1980 to 2010: the Global Burden of Disease 2010 study. Circulation. 2014;129(14):1483–92.CrossRefPubMedPubMedCentral
22.
go back to reference Stewart S, Riegel B, Boyd C, Ahamed Y, Thompson DR, Burrell LM, et al. Establishing a pragmatic framework to optimise health outcomes in heart failure and multimorbidity (ARISE-HF): a multidisciplinary position statement. Int J Cardiol. 2016;212:1–10.CrossRefPubMed Stewart S, Riegel B, Boyd C, Ahamed Y, Thompson DR, Burrell LM, et al. Establishing a pragmatic framework to optimise health outcomes in heart failure and multimorbidity (ARISE-HF): a multidisciplinary position statement. Int J Cardiol. 2016;212:1–10.CrossRefPubMed
24.
go back to reference Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, et al. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail. 2013;6(3):606–19.CrossRefPubMedPubMedCentral Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, et al. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail. 2013;6(3):606–19.CrossRefPubMedPubMedCentral
25.
26.
go back to reference Scantlebury DC, Borlaug BA. Why are women more likely than men to develop heart failure with preserved ejection fraction? Curr Opin Cardiol. 2011;26(6):562–8.CrossRefPubMed Scantlebury DC, Borlaug BA. Why are women more likely than men to develop heart failure with preserved ejection fraction? Curr Opin Cardiol. 2011;26(6):562–8.CrossRefPubMed
27.
go back to reference Lam CS, Donal E, Kraigher-Krainer E, Vasan RS. Epidemiology and clinical course of heart failure with preserved ejection fraction. Eur J Heart Fail. 2011;13(1):18–28.CrossRefPubMed Lam CS, Donal E, Kraigher-Krainer E, Vasan RS. Epidemiology and clinical course of heart failure with preserved ejection fraction. Eur J Heart Fail. 2011;13(1):18–28.CrossRefPubMed
28.
go back to reference Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006;355(3):251–9.CrossRefPubMed Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006;355(3):251–9.CrossRefPubMed
29.
go back to reference Stewart S, MacIntyre K, Hole DJ, Capewell S, McMurray JJ. More ‘malignant’ than cancer? Five-year survival following a first admission for heart failure. Eur J Heart Fail. 2001;3(3):315–22.CrossRefPubMed Stewart S, MacIntyre K, Hole DJ, Capewell S, McMurray JJ. More ‘malignant’ than cancer? Five-year survival following a first admission for heart failure. Eur J Heart Fail. 2001;3(3):315–22.CrossRefPubMed
31.
go back to reference Dickstein K, Vardas PE, Auricchio A, Daubert JC, Linde C, McMurray J, et al. 2010 Focused Update of ESC Guidelines on device therapy in heart failure: an update of the 2008 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure and the 2007 ESC guidelines for cardiac and resynchronization therapy. Developed with the special contribution of the Heart Failure Association and the European Heart Rhythm Association. Eur Heart J. 2010;31(21):2677–87.CrossRefPubMed Dickstein K, Vardas PE, Auricchio A, Daubert JC, Linde C, McMurray J, et al. 2010 Focused Update of ESC Guidelines on device therapy in heart failure: an update of the 2008 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure and the 2007 ESC guidelines for cardiac and resynchronization therapy. Developed with the special contribution of the Heart Failure Association and the European Heart Rhythm Association. Eur Heart J. 2010;31(21):2677–87.CrossRefPubMed
32.
go back to reference Inglis SC, Clark RA, McAlister FA, Ball J, Lewinter C, Cullington D, et al. Structured telephone support or telemonitoring programmes for patients with chronic heart failure. Cochrane Database Syst Rev. 2011;8:CD007228. Inglis SC, Clark RA, McAlister FA, Ball J, Lewinter C, Cullington D, et al. Structured telephone support or telemonitoring programmes for patients with chronic heart failure. Cochrane Database Syst Rev. 2011;8:CD007228.
33.
go back to reference McAlister FA, Stewart S, Ferrua S, McMurray JJ. Multidisciplinary strategies for the management of heart failure patients at high risk for admission: a systematic review of randomized trials. J Am Coll Cardiol. 2004;44(4):810–9.PubMed McAlister FA, Stewart S, Ferrua S, McMurray JJ. Multidisciplinary strategies for the management of heart failure patients at high risk for admission: a systematic review of randomized trials. J Am Coll Cardiol. 2004;44(4):810–9.PubMed
Metadata
Title
Current and projected burden of heart failure in the Australian adult population: a substantive but still ill-defined major health issue
Authors
Yih-Kai Chan
Camilla Tuttle
Jocasta Ball
Tiew-Hwa Katherine Teng
Yasmin Ahamed
Melinda Jane Carrington
Simon Stewart
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1748-0

Other articles of this Issue 1/2016

BMC Health Services Research 1/2016 Go to the issue