Prevalence of heart failure and left ventricular dysfunction in China: the China Hypertension Survey, 2012-2015

Guang Hao, Xin Wang, Zuo Chen, Linfeng Zhang, Yuhui Zhang, Bingqi Wei, Congyi Zheng, Yuting Kang, Linlin Jiang, Zhenhui Zhu, Jian Zhang, Zengwu Wang, Runlin Gao, China Hypertension Survey Investigators, Guang Hao, Xin Wang, Zuo Chen, Linfeng Zhang, Yuhui Zhang, Bingqi Wei, Congyi Zheng, Yuting Kang, Linlin Jiang, Zhenhui Zhu, Jian Zhang, Zengwu Wang, Runlin Gao, China Hypertension Survey Investigators

Abstract

Background: Heart failure (HF) is a major health burden worldwide. However, there is no nationwide epidemiological data on HF in China after 2000. The aims of this study are (i) to determine the prevalence of left ventricular (LV) dysfunction and HF (with reduced, mid-range, and preserved ejection fraction) in a nationally representative Chinese population, and (ii) to investigate the treatment and control of hypertension in HF patients.

Methods and results: Data from the China Hypertension Survey (CHS) and 22 158 participants were eligible for analysis in this study. For each participant, a self-reported history of HF and any other cardiovascular diseases was acquired. Two-dimensional and Doppler echocardiography was used to assess LV dysfunction. Overall, 1.3% (estimated 13.7 million) of the Chinese adult population aged ≥35 years had HF, 1.4% of participants had LV systolic dysfunction (ejection fraction <50%), and 2.7% were graded as having 'moderate' or 'severe' LV diastolic dysfunction. The weighted prevalence of HF was similar between urban and rural residents (1.6% vs. 1.1%, P = 0.266), and between men and women (1.4% vs. 1.2%, P = 0.632). In addition, among HF patients with hypertension, 57.7% received antihypertensive medication, and 14.5% had their blood pressure controlled <140/90 mmHg.

Conclusions: In summary, there was an increase in the prevalence of HF, and LV dysfunction was very common in China. However, treatment and control of hypertension in participants with HF were low.

Clinical trial registration number: ChiCTR-ECS-14004641.

Keywords: Blood pressure control; China; Heart failure; Left ventricular dysfunction.

© 2019 The Authors European Journal of Heart Failure © 2019 European Society of Cardiology.

References

    1. Ponikowski P, Anker SD, AlHabib KF, Cowie MR, Force TL, Hu S, Jaarsma T, Krum H, Rastogi V, Rohde LE, Samal UC, Shimokawa H, Budi Siswanto B, Sliwa K, Filippatos G. Heart failure: preventing disease and death worldwide. ESC Heart Fail 2014;1:4-25.
    1. Ambrosy AP, Fonarow GC, Butler J, Chioncel O, Greene SJ, Vaduganathan M, Nodari S, Lam CS, Sato N, Shah AN, Gheorghiade M. The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries. J Am Coll Cardiol 2014;63:1123-1133.
    1. Hunt SA. American College of Cardiology; American Heart Association Task Force on Practice Guidelines. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol 2005;46:e1-e82.
    1. Butler J, Fonarow GC, Zile MR, Lam CS, Roessig L, Schelbert EB, Shah SJ, Ahmed A, Bonow RO, Cleland JG, Cody RJ, Chioncel O, Collins SP, Dunnmon P, Filippatos G, Lefkowitz MP, Marti CN, McMurray JJ, Misselwitz F, Nodari S, O'Connor C, Pfeffer MA, Pieske B, Pitt B, Rosano G, Sabbah HN, Senni M, Solomon SD, Stockbridge N, Teerlink JR, Georgiopoulou VV, Gheorghiade M. Developing therapies for heart failure with preserved ejection fraction: current state and future directions. JACC Heart Fail 2014;2:97-112.
    1. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, Falk V, Gonzalez-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GM, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2016;18:891-975.
    1. Gu D, Huang G, He J. Investigation of prevalence and distributing feature of chronic heart failure in Chinese adult population. Zhonghua Xin Xue Guan Bing Za Zhi 2003;31:3-6.
    1. Yang YN, Ma YT, Liu F, Huang D, Li XM, Huang Y, Tang Q, Chen BD, Ma X, Xie X, Du L, Gao X, Wang YH, Gulinaer B, Yu ZX. Incidence and distributing feature of chronic heart failure in adult population of Xinjiang. Zhonghua Xin Xue Guan Bing Za Zhi 2010;38:460-464.
    1. Guo L, Guo X, Chang Y, Yang J, Zhang L, Li T, Sun Y. Prevalence and risk factors of heart failure with preserved ejection fraction: a population-based study in Northeast China. Int J Environ Res Public Health 2016;13:E770.
    1. Kuznetsova T, Herbots L, Jin Y, Stolarz-Skrzypek K, Staessen JA. Systolic and diastolic left ventricular dysfunction: from risk factors to overt heart failure. Expert Rev Cardiovasc Ther 2010;8:251-258.
    1. van Riet EE, Hoes AW, Wagenaar KP, Limburg A, Landman MA, Rutten FH. Epidemiology of heart failure: the prevalence of heart failure and ventricular dysfunction in older adults over time. A systematic review. Eur J Heart Fail 2016;18:242-252.
    1. Echouffo-Tcheugui JB, Erqou S, Butler J, Yancy CW, Fonarow GC. Assessing the risk of progression from asymptomatic left ventricular dysfunction to overt heart failure: a systematic overview and meta-analysis. JACC Heart Fail 2016;4:237-248.
    1. Hays AG, Sacco RL, Rundek T, Sciacca RR, Jin Z, Liu R, Homma S, Di Tullio MR. Left ventricular systolic dysfunction and the risk of ischemic stroke in a multiethnic population. Stroke 2006;37:1715-1719.
    1. Saczynski JS, Go AS, Magid DJ, Smith DH, McManus DD, Allen L, Ogarek J, Goldberg RJ, Gurwitz JH. Patterns of comorbidity in older adults with heart failure: the Cardiovascular Research Network PRESERVE study. J Am Geriatr Soc 2013;61:26-33.
    1. Lee DS, Vasan RS. Goals and guidelines for treating hypertension in a patient with heart failure. Curr Treat Options Cardiovasc Med 2006;8:334-344.
    1. Wang Z, Zhang L, Chen Z, Wang X, Shao L, Guo M, Zhu M, Gao R. China Hypertension Survey Goup. Survey on prevalence of hypertension in China: background, aim, method and design. Int J Cardiol 2014;174:721-723.
    1. Wang Z, Chen Z, Zhang L, Wang X, Hao G, Zhang Z, Shao L, Tian Y, Dong Y, Zheng C, Wang J, Zhu M, Weintraub WS, Gao R. China Hypertension Survey Investigators. Status of hypertension in China: results from the China Hypertension Survey, 2012-2015. Circulation 2018;137:2344-2356.
    1. Dong Y, Wang Z, Chen Z, Wang X, Zhang L, Nie J, Zheng C, Wang J, Shao L, Tian Y, Gao R. Comparison of visceral, body fat indices and anthropometric measures in relation to chronic kidney disease among Chinese adults from a large scale cross-sectional study. BMC Nephrol 2018;19:40.
    1. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ; Chamber Quantification Writing Group; American Society of Echocardiography's Guidelines and Standards Committee; European Association of Echocardiography. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005;18:1440-1463.
    1. Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, Evangelisa A. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr 2009;10:165-193.
    1. Dickstein K, Cohen-Solal A, Filippatos G, McMurray JJ, Ponikowski P, Poole-Wilson PA, Stromberg A, van Veldhuisen DJ, Atar D, Hoes AW, Keren A, Mebazaa A, Nieminen M, Priori SG, Swedberg K. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J 2008;29:2388-2442.
    1. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015;28:1-39.e14.
    1. Joint Committee for Guideline Revision. 2016 Chinese guidelines for the management of dyslipidemia in adults. J Geriatr Cardiol 2018;15:1-29.
    1. Stevens PE, Levin A. Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members. Evaluation and management of chronic kidney disease: Synopsis of the Kidney Disease: Improving Global Outcomes 2012 Clinical Practice Guideline. Ann Intern Med 2013;158:825-830.
    1. Chen CM, Kong LZ; China Obesity Problem Working Group. Chinese Adults Guidelines for the Prevention and Control of Overweight and Obesity. Beijing: People's Medical Publishing House; 2006.
    1. Writing Group of Chinese Guidelines for the Management of Hypertension. 2018 Chinese guidelines for the management of hypertension. J Geriatr Cardiol 2019;19:579-615.
    1. Census Office of the State Council of China, Division of Population and Employment Statistics, National Bureau of Statistics of China. Tabulation on the 2010 Population Census on the People's Republic of China. Beijing: China Statistics Press; 2012.
    1. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL; American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2013;62:e147-e239.
    1. Tromp J, Teng TH, Tay WT, Hung CL, Narasimhan C, Shimizu W, Park SW, Liew HB, Ngarmukos T, Reyes EB, Siswanto BB, Yu CM, Zhang S, Yap J, MacDonald M, Ling LH, Leineweber K, Richards AM, Zile MR, Anand IS, Lam CS; ASIAN-HF Investigators. Heart failure with preserved ejection fraction in Asia. Eur J Heart Fail 2019;21:23-36.
    1. Senni M, Iorio A, Seferovic P. Heart failure with preserved ejection fraction in Asia: the far side of the moon? Eur J Heart Fail 2019;21:37-39.
    1. Niedziela JT, Parma Z, Pawlowski T, Rozentryt P, Gasior M, Wojakowski W. Secular trends in first-time hospitalization for heart failure with following one-year readmission and mortality rates in the 3.8 million adult population of Silesia, Poland between 2010 and 2016. The SILCARD database. Int J Cardiol 2018;271:146-151.
    1. Kuznetsova T, Herbots L, Lopez B, Jin Y, Richart T, Thijs L, Gonzalez A, Herregods MC, Fagard RH, Diez J, Staessen JA. Prevalence of left ventricular diastolic dysfunction in a general population. Circ Heart Fail 2009;2:105-112.
    1. Zhang Y, Zhang J, Butler J, Yang X, Xie P, Guo D, Wei T, Yu J, Wu Z, Gao Y, Han X, Zhang X, Wen S, Anker SD, Filippatos G, Fonarow GC, Gan T, Zhang R; China-HF Investigators. Contemporary epidemiology, management, and outcomes of patients hospitalized for heart failure in China: results from the China Heart Failure (China-HF) registry. J Card Fail 2017;23:868-875.
    1. van den Berge JC, Constantinescu AA, Boiten HJ, van Domburg RT, Deckers JW, Akkerhuis KM. Short- and long-term prognosis of patients with acute heart failure with and without diabetes: changes over the last three decades. Diabetes Care 2018;41:143-149.
    1. Luscher TF. Heart failure and comorbidities: renal failure, diabetes, atrial fibrillation, and inflammation. Eur Heart J 2015;36:1415-1417.
    1. Rodeheffer RJ. Hypertension and heart failure: the ALLHAT imperative. Circulation 2011;124:1803-1805.
    1. Lindgren MP, Pirouzi Fard M, Smith JG, Sundquist J, Sundquist K, Zoller B. A Swedish nationwide adoption study of the heritability of heart failure. JAMA Cardiol 2018;3:703-710.
    1. Levy D, Larson MG, Vasan RS, Kannel WB, Ho KK. The progression from hypertension to congestive heart failure. JAMA 1996;275:1557-1562.
    1. He J, Ogden LG, Bazzano LA, Vupputuri S, Loria C, Whelton PK. Risk factors for congestive heart failure in US men and women: NHANES I epidemiologic follow-up study. Arch Intern Med 2001;161:996-1002.
    1. Guo Y, Zhao D, Liu J. Epidemiological study of heart failure in China. Cardiovasc Innov Appl 2015;1:47-55.
    1. Javaheri S, Javaheri S, Javaheri A. Sleep apnea, heart failure, and pulmonary hypertension. Curr Heart Fail Rep 2013;10:315-320.
    1. Kane GC, Karon BL, Mahoney DW, Redfield MM, Roger VL, Burnett JC Jr, Jacobsen SJ, Rodeheffer RJ. Progression of left ventricular diastolic dysfunction and risk of heart failure. JAMA 2011;306:856-863.
    1. Yousaf F, Collerton J, Kingston A, Kenny A, Davies K, Jagger C, Robinson L, Kirkwood TB, Keavney B. Prevalence of left ventricular dysfunction in a UK community sample of very old people: the Newcastle 85+ study. Heart 2012;98:1418-1423.

Source: PubMed

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