Heart Failure Epidemic: an Expected Phenomenon

Heart failure (HF) is a complex clinical syndrome affecting more than 23 million people world-wide.1) The incidence of HF is associated with age, and it has remained stable in the past several decades. With the aging of society, the prevalence of HF is expected to rise, and indeed, in 1994 the prevalence of HF was 90 per 1000 beneficiaries and increased to 121 per 1000 beneficiaries in 2003 in the USA.2) There are more than 5.1 million HF patients in the USA and 875000 new patients are diagnosed with HF each year. Despite improved survival in the last 3 decades with introduction of new disease modifying drugs (beta blockers, renin-angiotensin-system inhibitors, mineralocorticoid receptor antagonists, ivabradine and angiotensin-receptor-neprylisin inhibitor), and devices (implantable cardioverter defibrillator, cardiac resynchronizing therapy, left ventricular assisting devices) HF is still associated with high mortality and morbidity, and enormous socio-economic burden. Knowing the exact prevalence of HF is important for developing healthcare policy for its management. Until now, the prevalence of HF in Korea was unknown. In this edition of the Journal, Lim and colleagues reported the nationwide prevalence of HF in Korea for the first time, using data from the 2002-2013 National Sample Cohort based on the National Health Information Database.3) They reported that HF prevalence was 0.75% in 2002 and 1.53% in 2012. Interestingly, the projected HF prevalence is expected to be 1.89% and 3.35% in 2020 and 2040, respectively. By 2040, more than 1.7 million Koreans are expected to have HF. Korea is the most-rapidly aging society among the Organization for Economic Cooperation and Development countries; consequently, the prevalence of HF is expected to rise due to the change in population structure (Fig. 1). In addition, the westernization of lifestyle and an increasing prevalence of ischemic heart disease also contribute to the rise in HF prevalence. This is not a unique phenomenon confined to Korea, but an epidemic observed in other Asian countries and the world. Editorial