Epidemiological Aspects: Prevalence and Risk of Heart Failure Related to Blood Pressure

Abstract

Heart failure (HF) is a common, highly morbid, and costly clinical syndrome with a growing impact on global public health. The increase in HF prevalence in high-income countries is related to the aging of populations, whereas in middle- and low-income countries, it is also related to the increasing burden of hypertension and other cardiovascular risk factors. Hypertension is the most prevalent risk factor for HF. In high-income countries, hypertension, together with arrythmias and coronary artery disease, carries the highest population-attributable risk of HF. In low-income countries, hypertension and rheumatic heart disease play the main role in HF development. Approximately 40% of HF cases in men and 60% in women can be attributed to hypertension. The risk of HF attributable to hypertension is twofold higher in patients with a preserved ejection fraction (EF) as compared to those with a reduced ejection fraction. The absence of hypertension, obesity, and diabetes substantially prolongs HF-free survival and life expectancy. Treatment of hypertension, particularly in individuals aged over 60 years, is associated with the greatest reduction of HF compared to other cardiovascular events. The risk of heart failure decreases by 24% for each 5-mmHg reduction in systolic blood pressure.