What is heart failure?
Heart failure (HF) is a complex disease. It is a set of signs and symptoms (syndrome) that occur in the advanced stages of a wide variety of heart diseases. It is a syndrome that results from an alteration in the filling of the heart and/or the inability of the heart to ensure an adequate blood supply to the various organs of our body. The consequences on the health of patients and on their survival are very serious.
What are the causes of heart failure?
HF is the common final pathway of a wide variety of heart diseases, but there are two fundamental causes. The first is hypertensive heart disease, which is heart disease resulting from high blood pressure.
The second cause is ischemic heart disease, which is a disease of the arteries of the heart, called coronary arteries, which, when obstructed, cause angina pectoris and myocardial infarction. Other diseases, such as intrinsic diseases of the heart muscle, cardiomyopathies or valve diseases are also causes of HF.
Are there people with a greater predisposition to heart failure?
People who are more likely to develop HF are precisely those who are more predisposed to develop the main causes of HF, i.e. hypertensive heart disease and ischemic heart disease. Therefore, the list of predisposing factors for HF includes arterial hypertension, excess cholesterol, smoking, diabetes, overweight and obesity, sedentary lifestyle, and excessive salt and alcohol intake. All these factors are modifiable with hygienic-dietary measures and/or drugs and must be modified if we intend to combat this epidemic, since age, which is a fundamental factor, is not modifiable. Hence the importance of starting as early as possible to correct the factors that can be modified.
Affectation in Spain due to heart failure
The medium-term prognosis of HF is comparable to that of the most common cancers in our setting. Furthermore, the consumption of health care resources attributable to HF is enormous. It is estimated that HF is the cause of 3-5% of hospital admissions in our country and the first cause of hospital admission in persons over 65 years of age. Approximately 2% of total health care expenditure is allocated to HF. The number of annual hospitalizations for HF in Spain is around 90 000 and, in the period 2003-2011, the number of admissions for HF in persons over 65 years of age increased by 26%.
HF represents a major public health problem because it is a frequent, i.e., prevalent disease. In developed countries, approximately 2% of the adult population suffers HF, a percentage that increases exponentially with age to over 8% among those over 75 years of age. It should be taken into account that, from the 1991 population census to January 2012, the Spanish population over 65 years of age has increased by 50%. This high prevalence, together with the progressive aging of the population, allows us to qualify HF as a true epidemic of the 21st century.