That Other Pandemic

Congestive heart failure is on the rise, and the increase is more rapid in low- and middle-income countries where public health interventions and access to basic medicines have been lacking for years.

This is the finding of a new study authored by Nicola Luigi Bragazzi, a biostatistician, epidemiologist and medical doctor in the Laboratory for Industrial and Applied Mathematics at York University.

The first systematic analysis of the burden and underlying causes of heart failure in 195 countries and territories worldwide, the study shows that the number of patients worldwide nearly doubled from 33.5 million in 1990 to 64.3 million in 2017.

The results are published in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology.

For his study, Bragazzi used detailed information from the Global Burden of Disease study to examine the prevalence and underlying causes of heart failure globally over a period of 28 years.

Numbers and age-standardized rates of heart failure prevalence and years lived with disability were compared according to age, sex and socio-demographic index (SDI).

The data shows that nearly half of the global increase in the number of heart failure patients was in China (29.9 per cent) and India (16.6 per cent). Bragazzi identifies “an interplay of factors such as population growth and unhealthy behaviours including smoking and air pollution” as likely explanations.

He further observes that in these and other low- and middle-income countries, four basic medicines (aspirin, beta blockers, angiotensin-converting enzyme inhibitors and statins) are found to be generally unavailable or unaffordable for many populations, a situation which only compounds the problem.

“Heart failure represents a major global public health issue,” Bragazzi says.

“Scholars and workers in the field of public health, as well as decision- and policy-makers, can exploit the data provided in the study to develop ad hoc interventional programs to mitigate against the burden imposed by heart failure in their countries and territories. Moreover, it is of paramount importance to enhance people’s health literacy and awareness concerning the adoption of healthy lifestyles.”  ■