Heart failure in the general population of men - morbidity, risk factors and prognosis

Aims. To analyse the prevalence, aetiology and prognosis of heart failure. Methods and results. A random population sample of men (n = 7495) was examined at baseline in 1970-73 and followed until 1996. During up to 27 years, 937 men were hospitalized for heart failure. For the statistical analysis, odds ratios and 95% confidence intervals, multivariate logistic regression and time-dependent Cox analysis were used. The incidence rate was 2.1, 9.1 and 11.5 per 1000 person-years in the age groups 55-64. 65-74 and 75-79, and the prevalences were 0.6, 2.8 and 6.2%, respectively. Valvular heart disease was the aetiology in 5.5%, coronary heart disease only or in combination with hypertension in 58.8%,, and hypertension only in 20.3%, and various combinations with diabetes in 4.5%. Of the remaining 12.1%, 96% were smokers and 64% were registered for alcohol abuse. Risk factors were increasing age, myocardial infarction in the family, diabetes mellitus, chest pain, tobacco smoking, high coffee consumption, alcohol abuse, high body mass index, high blood pressure as well as treatment for hypertension, but not high total cholesterol or psychological stress. Mortality after the diagnosis was increased eight times. Conclusions. Coronary heart disease and hypertension were the most common concomitant diseases. Risk factors were similar to those in coronary heart disease, and also alcohol abuse, but not high total cholesterol, low physical activity or psychological stress. Mortality was high.