Epidemiology of heart failure.
Epidemiology of heart failure.
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DOI：
10.1002/ejhf.1858
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发表时间：
2020-08
影响因子：
18.2
通讯作者：
Hoes AW
中科院分区：
文献类型：
--
作者：
Groenewegen A;Rutten FH;Mosterd A;Hoes AW
大约25年前，心力衰竭综合征首次被描述为一种新兴的流行病。今天，由于人口不断增长和老龄化，心力衰竭患者的总数仍在继续上升。然而，心力衰竭的病例组合似乎正在演变。在某些人群中，发病率已经稳定下来，甚至可能在下降，但在相对年轻的人群中观察到令人震惊的相反趋势，这可能与肥胖的增加有关。此外，发生了明显的向心力衰竭过渡并保留了射血分数。虽然这种转变部分是人为的，但由于人们对心力衰竭作为一种影响整个左心室射血分数谱的疾病的认识有所提高，这种转变可以与肥胖相关疾病负担的增加和人口老龄化联系起来。同样，有证据表明，在低收入国家，心力衰竭患者的数量可能正在上升，这些国家面临着传染病和与西方式生活方式相关的疾病的双重负担。这些发现，再加上对心力衰竭死亡率下降速度低于以往的观察，表明我们尚未达到这一流行病的终结。在这篇综述中，不断发展的心力衰竭流行病学的观点，以辨别主要趋势和规划未来的方向。
The heart failure syndrome has first been described as an emerging epidemic about 25 years ago. Today, because of a growing and ageing population, the total number of heart failure patients still continues to rise. However, the case mix of heart failure seems to be evolving. Incidence has stabilized and may even be decreasing in some populations, but alarming opposite trends have been observed in the relatively young, possibly related to an increase in obesity. In addition, a clear transition towards heart failure with a preserved ejection fraction has occurred. Although this transition is partially artificial, due to improved recognition of heart failure as a disorder affecting the entire left ventricular ejection fraction spectrum, links can be made with the growing burden of obesity‐related diseases and with the ageing of the population. Similarly, evidence suggests that the number of patients with heart failure may be on the rise in low‐income countries struggling under the double burden of communicable diseases and conditions associated with a Western‐type lifestyle. These findings, together with the observation that the mortality rate of heart failure is declining less rapidly than previously, indicate we have not reached the end of the epidemic yet. In this review, the evolving epidemiology of heart failure is put into perspective, to discern major trends and project future directions.
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