Heart failure: a global disease requiring a global response.

نویسندگان

J E Sanderson

T-f Tse

چکیده

The heart is arguably the organ that suffers most obviously from increasing economic globalisation. Although mortality from coronary artery and cerebrovascular diseases has been declining in western Europe and North America since the mid to late 1970s, this is not the case elsewhere in the world. Increasing industrialisation and urbanisation, while raising living standards and increasing lifespan for many, is also accompanied by a change of diet (increased calories, fat and salt), cigarette smoking, lack of exercise, and obesity. Diabetes, hypertension, and coronary artery disease are the initial consequences and heart failure follows, which is the end product of myocardial damage caused by these disease processes alone or more usually in combination. In nearly all regions of the world heart failure is both common and on the rise. 4 In Hong Kong, based on admissions to a teaching hospital serving a large community, the incidence rate is 3–3.8/1000/year rising to 20/1000/year in women over the age of 85 years. This is comparable to rates in western countries that range from 1 to 5 cases/1000/year. And in Hong Kong there has been a 10% annual increase in hospital admissions over the past five years (unpublished data). In Africa, at least 3–7% of all hospital admissions are caused by heart failure. In South America cardiovascular disease is now the leading cause of death, and the prevalence rate of heart failure is about 4% in those older than 65 years. Similar prevalence rates were found in an Arab population.

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