Tromp Jasper, Teng Tiew-Hwa Katherine
Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Duke-NUS Medical School, Singapore.
Korean Circ J. 2024 Oct;54(10):591-602. doi: 10.4070/kcj.2024.0199. Epub 2024 Jul 17.
Heart failure (HF) epidemiology, patient characteristics, and clinical outcomes exhibit substantial regional variations, reflecting diverse etiologies and health system capacities. This review comprehensively analyses these variations, drawing on data from recent global registries and clinical trials. Our review indicates that ischemic and hypertensive heart diseases are prevalent globally but differ in dominance depending on the region. Notably, regions such as Africa and Latin America show higher instances of HF from hypertensive heart disease and Chagas cardiomyopathy, respectively. Moreover, disparities in age and comorbidity profiles across regions highlight younger populations with HF in lower-income countries compared to older populations in high-income regions. This review also highlights the global disparity in guideline-directed medical and device therapy, underscoring significant underuse in lower-income regions. These insights emphasize the need for targeted HF management strategies considering regional clinical and demographic characteristics to enhance global HF care and outcomes.
心力衰竭(HF)的流行病学、患者特征和临床结局存在显著的地区差异,反映了病因和卫生系统能力的多样性。本综述利用近期全球注册研究和临床试验的数据,对这些差异进行了全面分析。我们的综述表明,缺血性和高血压性心脏病在全球普遍存在,但根据地区不同,其主导情况有所差异。值得注意的是,非洲和拉丁美洲等地区分别显示出高血压性心脏病和恰加斯心肌病导致的HF发生率较高。此外,各地区在年龄和合并症谱方面的差异凸显了低收入国家HF患者较年轻,而高收入地区的患者年龄较大。本综述还强调了指南指导的药物和器械治疗在全球的差异,突出了低收入地区的显著使用不足情况。这些见解强调了需要考虑地区临床和人口特征制定有针对性的HF管理策略,以改善全球HF护理和结局。