Changing epidemiological features of cardiac failure

Important reductions in cardiovascular mor- tality that have occurred over the past three decades in most industrialised regions have not been accompanied by a decline in mortal- ity or admissions to hospital for cardiac failure. ' Congestive heart failure (CHF) continues to be a lethal end stage of cardiovascular disease caused by hypertension, coronary disease, valve deformity, diabetes, and cardiomyopathy. As premature deaths from these conditions are avoided by means of more effective medical and surgical interven- tions, the prevalence of cardiac failure can be expected to rise because the predisposing con- ditions are palliated, not cured. Increased size of the elderly population also increases the prevalence of heart failure.