CARDIOVASCULAR MEDICINE

Prevalence of impaired left ventricular systolic function and heart failure in a middle aged and elderly urban population segment of Copenhagen

I Raymond^1,*, F Pedersen¹, F Steensgaard-Hansen², A Green³, M Busch-Sorensen⁴, C Tuxen¹, J Appel¹, J Jacobsen⁵, D Atar¹, P Hildebrandt¹

¹ Department of Cardiology and Endocrinology E, H:S Frederiksberg University Hospital, Copenhagen, Denmark
² University Hospital of Copenhagen, H:S Rigshospitalet, Copenhagen, Denmark
³ Department of Epidemiology and Social Medicine, University of Aarhus, Aarhus, Denmark
⁴ Merck Research Laboratories, Glostrup, Denmark
⁵ Frederiksberg-Copenhagen, Denmark

Correspondence to:
Correspondence to:
Dr I Raymond
Department of Cardiology and Endocrinology E, H:S Frederiksberg University Hospital, University of Copenhagen, DK-2000 Frederiksberg, Denmark; ilan.raymond{at}dadlnet.dk

Objective: To assess the prevalence of impaired left ventricular systolic function and manifest heart failure in a general population aged 50–89 years.

Design: In this cross sectional survey, participants filled in a heart failure questionnaire. ECG, blood tests, and echocardiography were performed.

Setting: The study population was recruited from general practitioners situated in the same urban area and examined in a university hospital in Copenhagen, Denmark.

Participants: 764 participants (432 women and 332 men, median (SD) age 66 (11) years) participated. The study population was stratified to include a minimum of 150 persons in each age decade.

Main outcome measures: Prevalence of impaired systolic function and manifest heart failure.

Results: The prevalence of systolic dysfunction (left ventricular ejection fraction 40%) was more than twice as high among men (7.6%) as among women (2.6%). In the male population systolic heart failure (left ventricular ejection fraction 40% and symptoms) was found in 1.8% of the 50–59 years age group and approximately doubled for each age decade to reach 13.9% in octogenarians. Among women systolic dysfunction increased from 0.8% to 4.3% in the same age groups. Asymptomatic cases accounted for 44.0% of all cases of systolic dysfunction in the male population and only 9.1% in the female population.

Conclusions: In this age controlled population study impaired left ventricular systolic function and heart failure increased substantially with age and was more than twice as frequent among men as among women. Asymptomatic left ventricular dysfunction occurred more frequently in men than in women and was less prevalent with increasing age.

Keywords: epidemiology; prevalence; systolic function; heart failure

Abbreviations: ACE, angiotensin converting enzyme; CI, confidence interval; ECHOES, echocardiographic heart of England screening; HF, heart failure; LV, left ventricular; LVEF, left ventricular ejection fraction; LVH, left ventricular hypertrophy; MONICA, monitoring of trends and determinants in cardiovascular disease; OR, odds ratio; WMI, wall motion index

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