Study: 1 in 5 Will Get Heart Failure

But Survival Rates Are Better Than Ever

From the WebMD Archives

Nov. 4, 2002 -- First, the bad news: If you're 40 or older, you have a one-in-five chance of developing heart failure sometime in your life -- and the risk doubles if you have high blood pressure.

Now, the good news: One-third fewer women are getting heart failure compared with 50 years ago, and the chances of surviving -- for both sexes -- is better than ever.

So even though this disease continues to be the leading cause of hospitalizations in those 65 and older, it typically now occurs at a later age, and more people are living through it, say researchers in back-to-back studies measuring long-term trends in heart failure, which affects nearly 5 million Americans -- usually the elderly.

"I think it's very good news," says Daniel Levy, MD, of the National Heart, Lung, and Blood Institute, who is the lead researcher of a study in the Oct. 31 issue of The New England Journal of Medicine that tracked heart failure survival trends since the 1950s.

His study was published just one week before a study in the Nov. 5 issue of Circulation by researchers at the Framingham Heart Study, which also calculated the one-in-five lifetime risk.

"What was surprising to us was that the overall lifetime risk was as high in women as in men," lead researcher of the new study Donald Lloyd-Jones, MD, ScM, tells WebMD. "But we found there are different risk factors of congestive heart failure in men and women."

His study followed more than 8,000 Americans for nearly 25 years. None had heart failure at the start of the study.

He found that for women, uncontrolled high blood pressure is the No. 1 risk for later developing heart failure. For men, a previous heart attack is the main factor.

Heart failure occurs when the heart is not pumping as well as it should in delivering oxygen-rich blood to the body's cells. This weak pumping action causes a buildup of fluid in the lungs and other tissues.

"We hope our study raises awareness of the importance of the risk factors that face both men and women so the proper preventative measures can be taken," says Lloyd-Jones, of Harvard Medical School. For instance, women with normal blood pressure -- below a reading of 140 over 90 -- have a 12% lifetime risk of developing heart failure. But when their blood pressure is 160 over 100 or higher, that risk more than doubles to a nearly 29%, he says.

Men with normal blood pressure have a 15% chance of developing heart failure. With high blood pressure, the risk jumps to 28%.

While the overall lifetime risk for men has not changed, according to Lloyd-Jones, it has dramatically decreased among women -- partly because more women with high blood pressure are taking measures to lower it.

"We know from clinical trails that lowering blood pressure can reduce the risk of congestive heart failure in women by about half," Levy tells WebMD. "Few things we do in clinical practice can reduce risk of anything by half. This is preventative medicine at its best, so that's really good news."

Levy says that men, while still facing the same lifetime odds of heart failure, also fare better these days because more are surviving an initial heart attack, credited to advances in treatment.

But prevention is key when it comes to heart failure. This study shows that 59% of men and 45% of women now die within five years of being diagnosed with heart failure. But things are definitely looking up -- in the 1950s and 1960s, 70% men and 57% of women died within five years of diagnosis.