Prevalence of heart failure and left ventricular dysfunction in the general population - The Rotterdam Study

Aims To determine the prevalence of heart failure and symptomatic as well a s asymptomatic left ventricular systolic dysfunction in the general populat ion. Methods and Results In 5540 participants of the Rotterdam Study (age 68.9 /- 8.7 years, 2251 men) aged 55-95 years, the presence of heart failure was determined by assessment of symptoms and signs (shortness of breath, ankle oedema and pulmonary crepitations) and use of heart failure medication. In 2267 subjects (age 65.7 +/- 7.4 years, 1028 men) fractional shortening was measured. The overall prevalence of heart failure was 3.9% (95% CI 3.0 +/- 4.7) and did not differ between men and women. The prevalence increased wi th age, with the exception of the highest age group in men. Fractional shor tening was higher in women and did not decrease appreciably with age. The p revalence of left ventricular systolic dysfunction (fractional shortening < = 25%) was approximately 2.5 times higher in men (5.5%, 95% CI 4.1-7.0) th an in women (2.2%, 95% CI 1.4-3.2). Sixty percent of persons with left vent ricular systolic dysfunction had no symptoms or signs of heart failure at a ll. Conclusions The prevalence of heart failure is appreciable and does not dif fer between men and women. The majority of persons with left ventricular sy stolic dysfunction can be regarded as having asymptomatic left ventricular systolic dysfunction.