Heart failure poses an increasing problem for global healthcare systems. The epidemiological data which has
been accrued over the last thirty years has predominantly been accumulated from experience within North America and
Initial large cohort, prospective longitudinal studies produced the first publications; however latterly the focus has shifted
onto epidemiological data governing hospitalisation and mortality. The emphasis behind this shift has been the resource
implications with regards to repetitive, costly and prolonged hospitalisation. The European experience in heart failure,
though similar to North America has recently demonstrated differences in hospitalisation which may underlie the differences
between healthcare system configuration.
Heart failure however remains an increasing global problem and the endpoint of a variety of cardiovascular diseases. Allied
with the fact of increasingly elderly populations and prior data demonstrating a steep rise in prevalent cases within
more elderly populations, it is likely that the increasing burden of disease will continue to pose challenges for modern
Despite the predicted increase in the number of patients affected by heart failure, over the last thirty years, a clear management
algorithm has evolved for the use of pharmacotherapies (neuro-hormonal antagonists), device based therapies
(Implantable Cardioverting Defibrillator (ICD) and Cardiac Resynchronisation Therapy (CRT)) and mechanical therapies
including left ventricular assist devices and cardiac transplantation. Though the management of such patients has been
clearly delineated in national and international guidelines, the underuse of all available and appropriate therapies remains
a significant problem.
When comparing various epidemiological studies from different settings and timepoints, it should be remembered that
rates of prevalence and incidence may vary depending upon the definition used, methods of accumulating information
(with the possibility of bias) and the chosen cut point of defining left ventricular systolic dysfunction (LVSD).