Confirmation of a heart failure epidemic: findings from the Resource Utilization Among Congestive Heart Failure (REACH) study
Peter A. McCullough, MD, MPH, FACC, FACP*,*,
Edward F. Philbin, MD, FACC ,
John A. Spertus, MD, MPH, FACC ,
Scott Kaatz, DO, FACP ,
Keisha R. Sandberg, BS|| and
W. Douglas Weaver, MD, FACC||
* Departments of Basic Science and Internal Medicine, Cardiology Section, University of Missouri-Kansas City School of Medicine, Truman Medical Center, Kansas City, Missouri, USA
Albany Medical College, Albany, New York, USA
University of Missouri-Kansas City School of Medicine, Mid-America Heart Institute, Kansas City, Missouri, USA
Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan, USA
|| Henry Ford Heart and Vascular Institute, Detroit, Michigan, USA
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Figure 1 Age- and gender-adjusted incidence of congestive heart failure in an integrated health system from 1989 to 1999. p > 0.05 for linear trend in both groups.
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Figure 2 Age- and gender-adjusted prevalence and of congestive heart failure in an integrated health system from 1989 to 1999. For both men and women, the prevalence of congestive heart failure has tripled over the decade of the 1990s. p < 0.0001 for linear trend in women and men.
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Figure 3 Incident cases of heart failure in men (white bars) and women (black bars) by age group in the Resource Utilization Among Congestive Heart Failure study (REACH). *p < 0.0000001 for all pairwise comparisons.
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Figure 4 Incident cases of heart failure in race groups by age group in the Resource Utilization Among Congestive Heart Failure study. *p < 0.0000001 for African American (black bars) versus white (white bars) or other race (striped bars) groups.
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Figure 5 Case fatality rate per year among incident (white bars) and prevalent (black bars) cases in the Resource Utilization Among Congestive Heart Failure study. The higher mortality among incident cases relative to prevalent cases before 1994 most likely represents lead-time bias in the index case ascertainment algorithm. *p < 0.01.
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Figure 6 Age- and race-adjusted mortality for men and women with congestive heart failure in an integrated health system, 1989 to 1999. p < 0.0001.
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Figure 7 Age- and gender-adjusted mortality by race for patients with congestive heart failure in an integrated health system, 1989 to 1999. *p < 0.0001 for all pairwise comparisons.
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Figure 8 Age-stratified mortality, adjusted for gender and race, for patients with congestive heart failure in an integrated health system, 1989 to 1999. Age is taken at the time of diagnosis of heart failure. p < 0.0001 for all pairwise comparisons.
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