The prognosis of heart failure in the general population - The Rotterdam Study

Aims To determine the prognosis, cause of death, and its determinants in pa rticipants of the population-based Rotterdam Study who were found to have h eart failure. Methods and Results In 5255 Rotterdam Study participants (aged 68.9 +/- 8.6 years, 3113 women) the presence of heart failure was determined. Data were analysed with Cox's proportional-hazards models. One hundred and eighty-on e participants (age 77.3 +/- 7.9 years. 109 women) had heart failure. Of th ese 85 (47%) died during the 4.8-8.5 (mean 6.1) years of follow-up. One, 2 and 5 years' survival was 89%, 79%, and 59%, representing an age-adjusted m ortality twice that of persons without heart failure (hazard ratio 2.1, 95% CI 1.8-2.7). The hazard ratio for sudden death was even more pronounced: 4 .8, (95% Cl 2.6-8.7). Diabetes mellitus, impairment of renal function and a trial fibrillation were associated with a poor outcome. A higher blood pres sure and body mass index conferred a more favourable prognosis in those wit h heart failure. Conclusion Heart failure generally afflicts older subjects in the community , carries a poor prognosis, especially in the presence of concomitant disea ses, and confers a fivefold increase in the risk of sudden death.