Malaquin Dorothée, Tribouilloy Christophe
Service de cardiologie B, hôpital Sud, CHU d'Amiens, 80054 Amiens Cedex 1.
Rev Prat. 2010 Sep 20;60(7):911-5.
Heart failure is a common pathology sometimes considered as a "new epidemic". Its prevalence is increasing over the years since the cardiovascular management of patients is improving, and the Western population is aging. Prevalence is estimated to 9% in the 80-89 year-old patients, with a mean age of 75 at the onset of heart failure. The proportion of "diastolic heart failure" is about 40 to 55% of the total number of heart failure patients. Hypertension and ischemic cardiomyopathy are the most frequent aetiologies, but diabetes plays an increasing role. Prognosis of heart failure remains poor. Thus, five-year mortality rate is decreasing but remains higher than 50% in recent years. Furthermore, heart failure leads to more than 150 000 hospitalizations in France and the the cost of heart failure represents 1% of the total health expenditures. Thus, heart failure is a major and growing health problem. To reduce morbidity and mortality, we need to optimize therapy (both, pharmacologic and device therapy) and improve preventive measures, such as educational programs and multidisciplinary management in order to treat not only the disease itself but its aetiology, as well.
心力衰竭是一种常见的病理状况，有时被视为一种“新的流行病”。由于患者的心血管管理水平不断提高以及西方人口老龄化，其患病率多年来一直在上升。据估计，80至89岁患者的患病率为9%，心力衰竭发病时的平均年龄为75岁。“舒张性心力衰竭”在心力衰竭患者总数中所占比例约为40%至55%。高血压和缺血性心肌病是最常见的病因，但糖尿病的作用日益凸显。心力衰竭的预后仍然很差。因此，五年死亡率虽在下降，但近年来仍高于50%。此外，在法国，心力衰竭导致超过15万例住院病例，心力衰竭的治疗费用占卫生总支出的1%。因此，心力衰竭是一个重大且日益严重的健康问题。为了降低发病率和死亡率，我们需要优化治疗（包括药物治疗和器械治疗）并改进预防措施，如开展教育项目和进行多学科管理，以便不仅治疗疾病本身，还治疗其病因。
