The Public Health and Clinical Implications of the National Increase in Congestive Heart Failure

Abstract

The last two decades have witnessed a substantial decline in mortality due to myocardial infarction and stroke. However, during a similar period, data obtained from the National Center for Health Statistics indicate that the number of deaths due to congestive heart failure (CHF) has increased more than four-fold; for example, the number of deaths in which CHF was considered to be the underlying cause increased from about 6000 in 1955 to over 30,000 by 1982. There was a parallel increase in the number of deaths in which CHF was considered to be a contributing cause, from 51,000 in 1955 to about 246,000 in 1982. Although a substantial part of this increase can be explained by the aging of the population, the age-adjusted death rates also show a two-fold increase. For example, the age adjusted death rates, where CHF was the underlying cause, increased from 3.5/100,000 in 1968 to about 7.5/100,000 by 1984. The incidence of CHF and deaths due to CHF increased exponentially with age in both sexes and all races. However for any specific age group, CHF mortality is about 1.6 times commoner in men and about two to three times commoner in blacks compared to whites.