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Heart Failure Death Rates Dropping

Fewer Cases Diagnosed in Women; Number in Men Remains Same

WebMD Health News

Oct. 30, 2002 -- More people are surviving long after being told their heart is failing to pump enough blood to meet their body's needs. New research shows that the risk of dying after a diagnosis of heart failure has dropped by about a third among men and women in the last 50 years.

But the news isn't all rosy. Researchers say although people with heart failure are getting better treatment and living longer lives, more people are still developing the disease, and its not clear whether prevention strategies are becoming effective.

Nearly 5 million Americans suffer from heart failure, and 550,000 new cases are diagnosed each year. The condition usually develops slowly, over a period of years, and symptoms include shortness of breath, fluid buildup in the legs, ankles, and feet, weight gain, and fatigue.

The study, which appears in the Oct. 31 issue of TheNew England Journal of Medicine, is based on information collected by the Framingham Heart study from 1950 through 1999.

Researchers found that the number of heart failure deaths has dropped by an average of 12% per decade since 1950 among both men and women. Although the study authors can't exactly pinpoint the reason for those improved survival rates, evidence suggests that increased use of blood pressure-lowering drugs such as ACE inhibitors and beta-blockers among heart failure patients may have played a role.

But while the study found that the number of women diagnosed with heart failure has fallen by a third over the past 50 years, there hasn't been any significant reduction in new cases among men.

"The reason that new cases are on the decrease for women but not men may have to do with a gender difference in the causes," says study author Daniel Levy, MD, director of the Framingham Heart Study, in a news release. "Although high blood pressure and heart attack are important causes of heart failure in both men and women, uncontrolled hypertension is more prominent as a risk factor for the disease in women, while heart attack plays a greater role in men."

Researchers say treatment of high blood pressure has greatly improved in recent years, which might explain why fewer women are being diagnosed with the disease.

In contrast, they say improvements in the treatment of heart attack has led to an increase in the number of heart attack survivors who are at risk for developing heart failure, which might explain why a decline in heart failure was not found among men.

Heart failure is most common in adults over age 65, and with the proportion of Americans in that age bracket expected to rise dramatically in the coming years, health officials say prevention is key to stemming the current epidemic of heart failure.

"Prevention remains the best defense against heart failure," says Claude Lenfant, MD, director of the National Heart, Lung, and Blood Institute, in a news release. "Americans can greatly reduce their chances of developing it by taking steps to prevent or control high blood pressure, heart disease, and other conditions that can lead to heart failure."

Lenfant says heart failure still affects far too many Americans, and more than half of those who develop it die within five years of diagnosis. -->

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