THE ETIOLOGY OF HEART-FAILURE IN THE CHINESE POPULATION OF HONG-KONG - A PROSPECTIVE-STUDY OF 730 CONSECUTIVE PATIENTS

Heart failure is a common and serious condition in many parts of the w orld and is a frequent cause for hospital admission in the Chinese pop ulation of Hong Kong. There is no published Information on the epidemi ology of heart failure in this community or from mainland China. There fore, a prospective study of consecutive patients admitted with the cl inical diagnosis of heart failure has been carried out to identify the main risk factors or possible causes, and other clinical data. Seven- hundred thrity consecutive patients with cardiac failure were identifi ed and studied. Standard clinical criteria were used for diagnosis and identification of the main or most likely aetiologies and echocardiog raphy was done in 30%. The data analysis of the 730 patients showed th e following. The majority were females (56%) and the prevalence of hea rt failure increased with age (mean age 73.5 +/- 11.7 years) with 76% of the women > 70 years old. In contrast, the men were younger with 40 % < 70 years old. The main identifiable risk factors were hypertension (37%), ischemic heart disease (31%), valvular heart disease (15%), co r pulmonale (27%), idiopathic dilated cardiomyopathy (4%), and miscell aneous (10%). In women, hypertension was the commonest cause at all ag es but in men aged < 70 years ischemic heart disease was equal in freq uency to hypertension (36% and 35%, respectively). Twenty-one percent had diabetes compared to a community rate of 10% for this age group (o dds ratio 2.25, P < 0.0001). There was considerable overlap between di abetes, hypertension and ischemic heart disease. The estimated inciden ce rate was 3.8/1000 women and 3.0/1000 men aged >45 years old. This s tudy confirms that hypertension and ischaemic heart disease are major risk factors for the development of heart failure in the Chinese popul ation of Hong Kong and diabetes is a significant co-factor. There is s cope therefore for prevention to have a major impact.