The pandemic of the XXI century: chronic heart failure is the burden of the modern society. Epidemiology (literature review)

Chronic heart failure (CHF) is an important medical, social, and economic problem. Incidence, prevalence, and mortality from CHF remain high and prognosis still remains unfavorable. According to the American Heart Association (AHA), CHF has been named the leading cause of death among 283,000 people in 2008. According to European studies, the risk of developing CHF particularly high in the presence of such pathological conditions as coronary heart disease and diabetes. Studies revealed gender differences in CHF etiology. The presence of coronary artery disease, acute myocardial infarction, and stroke in men are the primary etiological factors of the CHF development. On the contrary, hypertension, diabetes mellitus, heart diseases, and myocarditis in the past medical history were more often verified as etiological causes in women. The relevance of HF becomes more significant with age: the reported prevalence is 0.3% among 20-29-year-old people, whereas in the group of patients older than 90 years, the average rate was about 70%. From the beginning of 1990s, researchers began to pay attention to patients with a preserved ejection fraction of the left ventricle (LV EF) and HF apart from patients with the traditional HF with reduced systolic function. Nowadays, large pool of factual data is accumulated arguing against generally accepted opinion that systolic dysfunction is the only hemodynamic cause responsible for onset and manifestation of HF. International studies show that the percentage of patients with preserved systolic function is approximately 40% to 70% (about 50% on average). Prognosis for patients with heart failure remains unfavorable. Only a comprehensive approach that includes widespread prevention, lifestyle changes, and the use of appropriate drugs, will provide an opportunity to overcome cardiological epidemic of the century - chronic heart failure.