Heart failure mortality in Spain, 1977-1998

Introduction and objectives. Heart failure is now the third leading cause of cardiovascular death in developed countries and is also an important cause of morbidity and hospitalization that now represents the main cause of admissions among the elderly. In this study we present heart failure mortality trends in Spain developing over the last 20 years. Methods. Data on deaths due to heart failure were obtained from files supplied by the Spanish National Institute for Statistics, We present age-adjusted specific mortality rates over time analyzed by sex and geographic area. Poisson regression models were used to estimate trends. Results. Heart failure is responsible for 4 to 8% of all-cause mortality in men and women, and for 12 to 20% of cardiovascular mortality overall, the the highest rates seen among the elderly and in Andalusia. The lowest rates are found in the Basque Country and some provinces of Castilla-Leon. Rates have tended to decrease over the last 20 years, but the rate of decrease has been slower in women, such that their mortality began to exceeded that of men from 1990 onwards. Mortality among the elderly has not changed significantly but the total number of deaths and morbidity are both increasing. Conclusions. Because the Spanish population is aging, we can foresee that chronic heart failure will require greater attention in the future.