ESTIMATING CLINICAL MORBIDITY DUE TO ISCHEMIC-HEART-DISEASE AND CONGESTIVE-HEART-FAILURE - THE FUTURE RISE OF HEART-FAILURE

被引:208
作者
BONNEUX, L
BARENDREGT, JJ
MEETER, K
BONSEL, GJ
van der Maas, PJ
机构
[1] ERASMUS UNIV ROTTERDAM, CTR THORAX, DEPT CARDIOL, 3000 DR ROTTERDAM, NETHERLANDS
[2] ERASMUS UNIV ROTTERDAM, INST MED TECHNOL ASSESSMENT, 3000 DR ROTTERDAM, NETHERLANDS
关键词
D O I
10.2105/AJPH.84.1.20
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objectives. Many developed countries have seen declining mortality rates for heart disease, together with an alleged decline in incidence and a seemingly paradoxical increase in health care demands. This paper presents a model for forecasting the plausible evolution of heart disease morbidity. Methods. The simulation model combines data from different sources. It generates acute coronary event and mortality rates from published data on incidences, recurrences, and lethalities of different heart disease conditions and interventions. Forecasts are based on plausible scenarios for declining incidence and increasing survival. Results. Mortality is postponed more than incidence. Prevalence rates of morbidity will decrease among the young and middle-aged but increase among the elderly. As the milder disease states act as risk factors for the more severe states, effects will culminate in the most severe disease states with a disproportionate increase in older people. Conclusions. Increasing health care needs in the face of declining mortality rates are no contradiction, but reflect a tradeoff of mortality for morbidity. The aging of the population will accentuate this morbidity increase.
引用
收藏
页码:20 / 28
页数:9
相关论文
共 54 条
[1]   1ST MYOCARDIAL-INFARCTION - AGE AND EJECTION FRACTION IDENTIFY A LOW-RISK GROUP [J].
AHNVE, S ;
GILPIN, E ;
DITTRICH, H ;
NICOD, P ;
HENNING, H ;
CARLISLE, J ;
ROSS, J .
AMERICAN HEART JOURNAL, 1988, 116 (04) :925-932
[2]  
[Anonymous], 1982, LANCET, V2, P1173
[3]   PROGNOSTIC-SIGNIFICANCE OF NONFATAL MYOCARDIAL REINFARCTION [J].
BENHORIN, J ;
MOSS, AJ ;
OAKES, D .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1990, 15 (02) :253-258
[4]  
BROOK RH, 1988, LANCET, V1, P750
[5]   A COMPARISON OF ENALAPRIL WITH HYDRALAZINE ISOSORBIDE DINITRATE IN THE TREATMENT OF CHRONIC CONGESTIVE-HEART-FAILURE [J].
COHN, JN ;
JOHNSON, G ;
ZIESCHE, S ;
COBB, F ;
FRANCIS, G ;
TRISTANI, F ;
SMITH, R ;
DUNKMAN, WB ;
LOEB, H ;
WONG, ML ;
BHAT, G ;
GOLDMAN, S ;
FLETCHER, RD ;
DOHERTY, J ;
HUGHES, CV ;
CARSON, P ;
CINTRON, G ;
SHABETAI, R ;
HAAKENSON, C .
NEW ENGLAND JOURNAL OF MEDICINE, 1991, 325 (05) :303-310
[6]   IDENTIFICATION AND TREATMENT OF LOW-RISK PATIENTS AFTER ACUTE MYOCARDIAL-INFARCTION AND CORONARY-ARTERY BYPASS GRAFT-SURGERY [J].
DEBUSK, RF ;
BLOMQVIST, CG ;
KOUCHOUKOS, NT ;
LUEPKER, RV ;
MILLER, HS ;
MOSS, AJ ;
POLLOCK, ML ;
REEVES, TJ ;
SELVESTER, RH ;
STASON, WB ;
WAGNER, GS ;
WILLMAN, VL .
NEW ENGLAND JOURNAL OF MEDICINE, 1986, 314 (03) :161-166
[7]   STEPWISE RISK STRATIFICATION SOON AFTER ACUTE MYOCARDIAL-INFARCTION [J].
DEBUSK, RF ;
KRAEMER, HC ;
NASH, E .
AMERICAN JOURNAL OF CARDIOLOGY, 1983, 52 (10) :1161-1166
[8]  
DECOCK CC, 1991, NED TIJDSCH CARDIOL, V5, P96
[9]   ONE-YEAR FOLLOW-UP RESULTS OF THE 1985-1986 NATIONAL-HEART-LUNG-AND-BLOOD-INSTITUTES PERCUTANEOUS TRANS-LUMINAL CORONARY ANGIOPLASTY REGISTRY [J].
DETRE, K ;
HOLUBKOV, R ;
KELSEY, S ;
BOURASSA, M ;
WILLIAMS, D ;
HOLMES, D ;
DORROS, G ;
FAXON, D ;
MYLER, R ;
KENT, K ;
COWLEY, M ;
CANNON, R ;
ROBERTSON, T .
CIRCULATION, 1989, 80 (03) :421-428
[10]   EVALUATION OF PATIENTS AFTER ACUTE MYOCARDIAL-INFARCTION - INDICATIONS FOR CARDIAC-CATHETERIZATION AND SURGICAL INTERVENTION [J].
EPSTEIN, SE ;
PALMERI, ST ;
PATTERSON, RE .
NEW ENGLAND JOURNAL OF MEDICINE, 1982, 307 (24) :1487-1492