Mortality from heart failure in an English population, 1979-2003: study of death certification.
OBJECTIVE
It is widely held that there will be an epidemic of heart failure in Europe and North America as a result of increased survival from myocardial infarction and other coronary heart disease. The study objective was to discover if the decline in mortality from coronary heart disease has been accompanied by a rise in mortality from heart failure in the study population.


METHODS
Analysis of database of mortality records including all certified causes of death, not just the underlying cause, from 1979-2003.


METHODS
Former Oxford NHS Region, England.


METHODS
Data from death certificates of all who died in the population covered.


RESULTS
Mortality rates for heart failure fell at very similar rates as those from coronary heart disease. In men, the average annual fall in mortality from coronary heart disease was -2.7% (95% confidence intervals -2.8 to -2.5) and that from heart failure was -2.9% (-3.2 to -2.5). In women, the average annual fall in mortality from coronary heart disease was -2.3% (-2.6 to -2.1) and that from heart failure was -2.6% (-3.0 to -2.3).


CONCLUSIONS
The decline in mortality from coronary heart disease has not been accompanied by a rise in mortality from heart failure. A future epidemic of heart failure, as a consequence of the decline in mortality from coronary heart disease, seems unlikely.
Goldacre
Michael J
MJ
Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK. michael.goldacre@dphpc.ox.ac.uk
Mant
David
D
Duncan
Marie
M
Griffith
Myfanwy
M
D017677:Age Distribution; D002303:Cardiac Output, Low / Q000401:mortality*; D003327:Coronary Disease / Q000401:mortality; D003644:Death Certificates; D004739:England / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000401:mortality; D006801:Humans; D008297:Male; D017678:Sex Distribution