• heart failure

Many studies have reported declining rates of heart failure hospitalisations since the 1990s.1 However, there is increasing evidence that these trends differ by age. Typically, heart failure is a common and insidious disease with substantial associated morbidity and mortality burden worldwide. This has led to a significant focus on improving treatments and medical therapy for this condition, particularly in older populations. Although heart failure is seen as a disease of the elderly, new research suggests that younger patients are being hospitalised for heart failure at an increasing and alarming rate.

Chan and colleagues2 report on trends in incident heart failure hospitalisations for the population of New Zealand between 2006 and 2018. Importantly, they suggest a differential trend by age, with incidence in patients aged <50 years increasing on average by 1.5% per year during the study period. In people aged between 50 and 79 years, trend analyses showed generally declining rates until 2013, when rates in men and women in these middle age groups started rising. These trends contrast with those in people aged over 80 years, where a consistent linear decline over the 13-year study period was noted. Comparable trends in younger adults have been reported from a number of whole population studies, including from Denmark,3 Sweden4 and Western Australia,5 yet it is unclear as to why these trends are occurring. The increases in younger age groups reported from these studies were around 50% over study periods between 16 and 20 years, a likely greater magnitude of increase compared with that reported by Chan. The timing of rising incidence rates between populations varies somewhat, with increases in Denmark3 and Sweden4 …