Heart Failure in an Aging Society

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Two fundamental factors determine the growing prevalence of heart failure in the Western hemisphere: average life expectancy and age-adjusted incidence of chronic heart failure (CHF).

Since the 1840s the average maximum life expectancy has been increasing at a constant rate of 3 months per year with no change in sight.1 In most industrialized societies the age group over 65 years is the fastest growing proportion.

It is exactly in this age group that CHF is most prevalent: 6.6% of all women and 6.8% of all men between 65 and 74 years are affected by CHF in the US. This number climbs to nearly 10% above 75 years of age (Figure 19-1).2

The combined impact of the aging population and the age distribution of CHF has caused an epidemic growth in disease numbers. In the 22 years between 1979 and 2001 hospital discharges for CHF rose by 164% and today 79% of all hospitalized patients are older than 65 years.2 Elderly patients with CHF pose a special task for cardiac rehabilitation because of the overlap of age-related and disease-associated impairment of exercise tolerance.

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