Prevalence of Self-Reported Heart Failure Among US Adults: Results from the 1999 National Health Interview Survey

Hanyu Ni, BM, MPH, PhD

Disclosures

Am Heart J. 2003;146(1) 

In This Article

Abstract and Introduction

Objective: The objective of the present study was to determine the prevalence of self-reported heart failure among US adults.
Methods: Data from the 1999 National Health Interview Survey were analyzed. A total of 30,801 sampled adults aged 18 years were given a list of major medical conditions, which included heart failure (HF), and asked if they had ever been told by a doctor or other health professional that they had any of the conditions. Analyses were conducted with the use of SUDAAN software to account for the complex sample design.
Results: An estimated 2.4 million adults had been told by a doctor or other health professional that they had HF. The prevalence of self-reported HF for age groups 18 to 39, 40 to 64, 65 to 74, and 75 to 105 years were 0.1%, 1.1%, 3.6%, and 5.5%, respectively. HF was most prevalent among ever-smokers, obese persons, and persons aged 65 years. No difference was found in the prevalence of self-reported HF between black and white persons. The most common comorbid conditions for those with HF were hypertension, coronary heart disease, and diabetes. Compared with those without HF, the elderly persons with HF were 8 times as likely to have severe mobility difficulties and 2 to 3 times as likely to have severe depression. Half of the elderly persons with HF had been hospitalized, visited an emergency room, or had 10 clinic visits in the past year. Black patients were more likely than white patients to have been unable to pay for prescription medicine and to have seen a medical specialist during the past year.
Conclusions: This nationally representative survey indicates that an estimated 2.4 million adults had been told by a doctor or other health professional that they had heart failure. Black patients with HF were less likely than white patients to have received the needed care.

Heart failure is a syndrome that develops as a consequence of many forms of heart disease and is manifested by symptoms and signs of abnormal cardiac ventricular performance. Because of its potential medical and economic impact, estimating the national prevalence of heart failure is essential for health care planning. Earlier studies based on hospital records and death certificates indicated an increase in the prevalence of heart failure since 1980, possibly as a result of improved survival of patients with myocardial infarction and the increasing proportion of the population that is elderly.[1,2,3] The Framingham Heart Study reported an age-adjusted heart failure prevalence of 0.7% for the 1980s, based on a local population sample.[4] The results from the National Health and Nutrition Examination Surveys (NHANES) I-III also reveal increasing prevalence of heart failure over the 3 periods surveyed: 1971 to 1975, 1976 to 1980, and 1988 to 1991.[5,6] Recent population-based data, however, are not available to systematically characterize the current population burden from heart failure in the United States.

The National Health Interview Survey (NHIS), conducted annually by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention, provides data on major medical conditions among US adults. The objectives of this study were to describe the prevalence and comorbidities of self-reported heart failure among US adults by using data from the 1999 NHIS to assess the physical and mental health status of patients with heart failure and to measure their utilization of health care services.

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