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Heart Failure - Prognosis

What is the prognosis for someone with heart failure?

Heart failure remains one of the most serious types of heart disease. The outlook for a woman with heart failure depends on her age, overall health, the severity of the condition, and how well she follows and responds to treatment.

Over the past 50 years, the overall chance of a woman dying of heart failure has dropped.27 The earlier the stage when your heart failure is diagnosed, the better your chance of surviving. Women in stage A of the AHA/ACC heart failure staging system can be treated to prevent or slow the progression of heart failure to a more advanced stage. A study of 2029 patients (52% were women) found that the heart failure stages were associated with worsening 5-year survival rates: from 97% in stage A and 96% in stage B to 75% in stage C and 20% in stage D.28

Survival is better for women with milder symptoms of heart failure. The milder your heart failure symptoms are, the more they can be eased with treatment and the better your prognosis will be. Women with NYHA class 1 heart failure symptoms do better than women with the more severe class 4 symptoms.29, 30 A study of 3726 patients (25% were women) found that 66% of patients with NYHA classes 1 and 2 symptoms survived for at least 3 years, compared with 58% of patients with NYHA classes 3 and 4 symptoms.29

Women with heart failure survive longer than men, perhaps because women tend to live longer than men.2, 10, 27, 31, 32 Some researchers think it is related to the cause of the heart failure. Women tend to have heart failure mostly due to high blood pressure,30 which develops gradually over a long period of time. Men are more likely to have heart failure as a result of coronary artery disease or heart attack, which can damage the heart muscle more severely and more quickly by depriving it of oxygen. When women develop heart failure caused by a heart attack or coronary artery disease, they do worse than women with heart failure due to other causes.32, 33 Other researchers argue that women with heart failure have a better survival rate than men regardless of what caused the heart failure.2

The prognosis for someone with heart failure varies from person to person and is based on individual factors, such as the cause and severity of heart failure. There is much that you and your doctor can do to improve the quality of your life and your chances of survival, such as risk factor management, lifestyle modifications, and various forms of treatment.

References

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  2. O'Meara E, Clayton T, McEntegart MB, et al. Sex Differences in Clinical Characteristics and Prognosis in a Broad Spectrum of Patients With Heart Failure: Results of the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) Program. Circulation. June 19, 2007;115(24):3111-3120.
  3. Rosamond W, Flegal K, Furie K, et al. Heart disease and stroke statistics--2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. Jan 29 2008;117(4):e25-146.
  4. Lloyd-Jones DM, Larson MG, Leip EP, et al. Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation. Dec 10 2002;106(24):3068-3072.
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  8. Schocken DD, Benjamin EJ, Fonarow GC, et al. Prevention of Heart Failure: A Scientific Statement From the American Heart Association Councils on Epidemiology and Prevention, Clinical Cardiology, Cardiovascular Nursing, and High Blood Pressure Research; Quality of Care and Outcomes Research Interdisciplinary Working Group; and Functional Genomics and Translational Biology Interdisciplinary Working Group. Circulation. May 13, 2008;117(19):2544-2565.
  9. Kenchaiah S, Evans JC, Levy D, et al. Obesity and the Risk of Heart Failure. N Engl J Med. August 1, 2002;347(5):305-313.
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  11. Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26- year follow-up of participants in the Framingham Heart Study. Circulation. 1983;67(5):968-977.
  12. Maron BJ, Towbin JA, Thiene G, et al. Contemporary Definitions and Classification of the Cardiomyopathies: An American Heart Association Scientific Statement From the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation. April 11, 2006;113(14):1807-1816.
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  26. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report. JAMA. May 21, 2003;289(19):2560-2571.
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  33. Ghali JK, Krause-Steinrauf HJ, Adams KF, et al. Gender differences in advanced heart failure: insights from the BEST study. J Am Coll Cardiol. Dec 17 2003;42(12):2128-2134.

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