Prevalence of heart failure stages in the general population and implications for heart failure prevention: reports from the China Hypertension Survey 2012–15

Author:

Cai Anping1ORCID,Zheng Congyi2,Qiu Jiayuan3,Fonarow Gregg C4ORCID,Lip Gregory Y H56,Feng Yingqing1,Wang Zengwu2

Affiliation:

1. Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University , No.106, Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080 , China

2. Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences , No. 15 (Lin), Fengcunxili, Mentougou District, Beijing 102308 , China

3. Department of Epidemiology, School of Public Health, Medical College of Soochow University , Suzhou 201701 , China

4. Division of Cardiology, Department of Medicine, Geffen School of Medicine at UCLA , Los Angeles, CA , USA

5. Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital , Liverpool , UK

6. Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University , Aalborg , Denmark

Abstract

Abstract Aims There are no nationwide epidemiological data on heart failure (HF) stages in China. Knowledge of the prevalence of HF stages is crucial for planning HF prevention and management strategies. We aimed to evaluate the prevalence of HF stages in the general Chinese population and the specific prevalence by age, sex, and urbanity. Methods and results This is a cross-sectional study and national representative general population aged ≥ 35 years (n = 31 494, mean age 57.4 years, women 54.1%) were obtained from the China Hypertension Survey. Participants were divided into Stage A (at-risk for HF), Stage B (pre-HF), and Stage C (symptomatic HF). Survey weights were calculated based on the 2010 China population census data. The prevalence of Stage A was 35.8% (≈245.1 million), Stage B 42.8% (≈293.1 million), and Stage C 1.1% (≈7.5 million). The prevalence of Stages B and C increased with increasing age (P < 0.0001). Women had lower prevalence of Stage A (32.6% vs. 39.3%; P < 0.0001) but higher prevalence of Stage B (45.9% vs. 39.5%; P < 0.0001) than men. People from rural area had lower prevalence of Stage A (31.9% vs. 41.0%; P < 0.0001) but higher prevalence of Stage B (47.8% vs. 36.2%; P < 0.0001) than people from urban. The prevalence of Stage C was similar by sex and urbanity. Conclusion The burdens of pre-clinical and clinical HF are high and vary by age, sex, and urbanity in China. Targeted interventions are needed to reduce the high burden of pre-clinical and clinical HF.

Funder

National Key R&D Program of China

Projects in the Chinese National Science & Technology Pillar Program

National Key Research and Development Program

Climbing Plan of Guangdong Provincial People's Hospital

Guangdong Provincial Clinical Research Center for Cardiovascular Disease

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Epidemiology

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