Heart failure-part of the old-age “epidemic”

Heart failure-part of the old-age “epidemic” 

You see a lot written about heart failure these days. It’s been called “an emerging epidemic in the Medicare population.”

There is no “epidemic” of heart failure.

What there is, though, is a burgeoning elderly population that will, naturally, increase the number of deaths each year.

There are only a few ways the Grim Reaper collects his customers: via trauma, renal failure, respiratory failure, and heart failure. Doesn’t cancer cause death, you might ask? No, it doesn’t: It causes one of the above, and that’s what kills you-the same is true for infection, Alzheimer’s disease, AIDS, and even stroke.

In the Archives of Internal Medicine, researchers report on “the dismal prognosis for heart failure in older persons.” Of course, it’s dismal. Death is always dismal except in the movies. It’s like the old adage says: “Everybody wants to go to heaven, but nobody wants to die.” That’s the way I make my living-helping you to delay the slamming of the door.

“As the U.S. population ages, the number of heart-failure patients over 65 is expected to double. While death rates have declined for coronary heart disease, stroke, and most complications of hypertension, the mortality of heart failure seems to be unchanged in recent decades,” reports the author of this study. What is happening is that science has reduced the mortality rate from hardening of the arteries, which causes the three diseases mentioned above.

The researchers added that, based on data from the Framingham Heart Study in 1993, survival following a diagnosis of heart failure might be worse than the prognosis for most types of cancer.

The recognized major risk factors for developing heart failure are myocardial infarction, coronary artery disease, diabetes, and hypertension. Although effective treatment of these conditions has improved considerably in recent years, there is no evidence that this has had a beneficial spillover effect on the prognosis for patients who have developed heart failure.

Archives of Internal Medicine, 159:505-510, 1999