Abstract

Heart failure casts a shadow over the last phase of life of many people. Symptoms of heart failure start to happen when the function of the heart as a pump becomes insufficient. This results mainly in shortness of breath and fluid congestion in the lungs and lower extremities. Between 20 and 30% of all people will experience heart failure, usually when they are 70 years old or above. Currently, approximately 1% of the adult Dutch population suffers from heart failure (approximately 130,000 individuals). It is expected that due to the ageing of the population, the number of heart failure patients will increase by fifty percent (estimate for 2025: 195,000 individuals) between now and the year 2025. Hospital admissions and treatment of patients with severe symptoms are associated with high costs. These are the findings of a review of the literature supplemented with (computer) simulated forecasts performed by the National Institute for Public Health and the Environment (RIVM). Focus on controling high blood pressure and combatting obesity: Individuals can reduce their risk of heart failure by avoiding its risk factors, in particular high blood pressure and myocardial infarction. The recommended measures for the prevention of cardiovascular disease in general (healthy nutrition, sufficient exercise, no smoking, et cetera) are also effective in preventing heart failure. Most health gains can be achieved by lifelong management of high blood pressure. The same applies to overweight and diabetes. People at increased risk of heart failure, such as those with a history of a myocardial infarction or diabetics, could be offered more intensive guidance. Amongst healthcare professionals there is an increased interest in early recognition and selective prevention of heart failure. If heart dysfunction could be recognised before symptoms emerge, life style adaptations or appropriate medication could postpone or even prevent heart failure. For the time being, a suitable test is lacking.