A new study from Duke University Medical Center challenges part of the assumption that, as the U.S. population ages, the incidence of heart failure will continue to rise. The study finds that heart failure is actually declining among the very elderly, yet the number of heart failure cases overall continues to rise (to learn more, see the Duke University Web site at http://www.dukemednews.org/news/article.php?id=10250.)

This Duke study found the incidence of heart failure fell most sharply among those aged 80- 84 years old, from 57.5 to 48.4 per 1,000 person years. It increased from 17.5 cases to 19.3 cases per 1,000 person years among those aged 65-69 years.

“Heart failure is largely a disease of aging, so we were surprised by the findings,” said Dr. Lesley Curtis, a health services researcher at Duke and lead author of the study that appeared in the February 25 issue of the Archives of Internal Medicine. However, Curtis said indications are that heart failure will continue to be a major public health burden;  nearly 5 million people in the U.S. suffer from heart failure, and even though mortality from the disease has fallen slightly, it remains a very serious problem.

According to Duke University, carefully documenting the incidence of a disease (the rate at which it occurs) and the prevalence (how many people have it at any one time) is important, as such projections have a direct impact on planning and resources needed for future care.

Here is a sample from the Duke study:

DURHAM, N.C. – Conventional wisdom holds that as the U.S. population ages, the incidence of heart failure will continue to rise. A new study from Duke University Medical Center challenges part of that assumption, however, finding that heart failure is actually declining among the very elderly. Yet the number of heart failure cases overall continues to rise.“Heart failure is largely a disease of aging, so we were surprised by the findings,” says Dr. Lesley Curtis, a health services researcher at Duke and lead author of the study appearing in the February 25 issue of the Archives of Internal Medicine.Carefully documenting the incidence of a disease – the rate at which it occurs – and the prevalence – how many people have it at any one time – is critically important, because projections have direct bearing upon planning and resources needed for future health care.

Curtis and her colleagues examined data from a five percent sample of Medicare beneficiaries’ claims between 1994 and 2003 and found that during that period, 622,789 patients were diagnosed with heart failure.

While the incidence of heart failure fell most sharply among those aged 80 to 84 years old, from 57.5 to 48.4 per 1000 person years, it also rose from 17.5 cases to 19.3 cases per 1000 person-years among those aged 65 to 69 years old.

The study also found that the total number of Americans living with heart failure steadily increased over the ten-year study period, from about 140,000 to 200,000, with more men living with the disease than women.

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