Current Status of Heart Failure in China

Abstract

As a serious and terminal stage of multiple cardiovascular diseases, heart failure (HF) is one of the most critical components of the current global strategies for the prevention and management of chronic diseases. With aging and the increased incidence of various cardiovascular diseases and related risk factors in the population, HF has also become a main reason for hospitalization and death of the elderly in China, which has resulted in a heavy burden on public health system and the economy. A 2003 report suggested that the prevalence of HF in China was 0.9%, higher in women than in men, and is increasing in proportion with aging. Although the mortality rate of HF seen in hospitals has declined, the long-term prognosis of HF in China is discouraging as demonstrated by a 3-year mortality rate of approximately 30%. HF diagnosis by brain natriuretic peptide, N-terminal pro-B-type natriuretic peptide, and echocardiography in China is unsatisfactory. Room for improvement is needed in drug and nondrug HF treatment in China. Intensive efforts are also needed to promote a real-world use of the current guidelines for recommended drugs that could improve HF patients' prognosis, including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and β-blockers. Much work is also needed to embrace the concept of HF management and systems in China. In the future, more attention should also be given to domestic epidemiological and clinical study of HF, focusing on transformation of experimental results to a clinic setting, and ongoing recognition of and attention to HF preserved ejection fraction. An efficient HF management system in China should also highlight the importance of establishing the most cost-effective prevention and therapy strategies.