title: Congestive heart failure in the community: a study of all incident cases in Olmsted County, Minnesota, in 1991.
abstract: BACKGROUND
  Data are limited regarding the classification and prognosis of patients with congestive heart failure (CHF) in the community.
  
  
  RESULTS
  Using the resources of the Rochester Epidemiology Project, we evaluated all patients receiving a first diagnosis of CHF in Olmsted County, Minnesota, in 1991 (n=216). Among these patients, 88% were >/=65 years and 49% were >/=80 years of age. The prognosis of patients with a new diagnosis of CHF was poor; survival was 86+/-2% at 3 months, 76+/-3% at 1 year, and 35+/-3% at 5 years. Of the 216 patients, 137 (63%) had an assessment of ejection fraction. In these patients, systolic function was preserved (ejection fraction >/=50%) in 59 (43%) and reduced (ejection fraction <50%) in 78 (57%). Survival adjusted for age, sex, NYHA class, and coronary artery disease was not significantly different between patients with preserved and those with reduced systolic function (relative risk, 0.80; P=0.369). ACE inhibitors were used in only 44% of the total population with CHF.
  
  
  CONCLUSIONS
  The present study reports the clinical characteristics and natural history of CHF as it presents in the community in the vasodilator era. CHF is a disease of the "very elderly," frequently occurs in the setting of normal ejection fraction, and has a poor prognosis, regardless of the level of systolic function. Diagnostic and therapeutic methods are underused in the community.
authors.affiliation: Division of Cardiovascular Diseases and Internal Medicine, Department of Health Sciences Research, and the Division of Community Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
authors.forename: M
authors.initials: M
authors.lastname: Senni
authors.forename: C M
authors.initials: CM
authors.lastname: Tribouilloy
authors.forename: R J
authors.initials: RJ
authors.lastname: Rodeheffer
authors.forename: S J
authors.initials: SJ
authors.lastname: Jacobsen
authors.forename: J M
authors.initials: JM
authors.lastname: Evans
authors.forename: K R
authors.initials: KR
authors.lastname: Bailey
authors.forename: M M
authors.initials: MM
authors.lastname: Redfield
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003153:Community Health Services / Q000706:statistics & numerical data; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008910:Minnesota; D011379:Prognosis; D012189:Retrospective Studies; D013318:Stroke Volume; D015996:Survival Rate