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Most patients with heart failure today are treated by primary care practitioners, not cardiologists.

Heart failure contributes directly or indirectly to approximately 260,000 deaths annually.

Median survival after the onset of heart failure is 1.7 years for men and 3.2 years for women, and the 5-year mortality rate is about 50%. In 1996, heart failure was listed as the primary diagnosis in 870,000 hospital discharges. Moreover, heart failure may be an associated condition in as many as 2.5 million additional discharges annually. Heart failure is the leading cause of hospitalization in persons 65 years of age and older. One third of patients who are hospitalized for heart failure either die or require readmission within 60 days of hospital discharge, and one half are readmitted within 90 days.

In 1991, health care costs for heart failure totaled $38.1 billion, or 5.4% of estimated total health care expenditures for that year. An estimated $23.1 billion was spent on inpatient care, $14.7 billion on outpatient care, and $270 million on heart transplantations. The total figure does not include indirect costs of heart failure, such as lost productivity and decreased quality of life.

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American Heart Association: 1999 Heart and Stroke Statistical Update. Dallas, Tex, American Heart Association, 1998

Kannel WB, Belanger AJ: Epidemiology of heart failure. Am Heart J 1991; 121:951-957

Chin MH, Goldman L: Correlates of early hospital readmission or death in patients with congestive heart failure. Am J Cardiol 1997; 79:1640-1644

Vinson JM, Rich MW, Sperry JC, et al: Early readmission of elderly patients with congestive heart failure. J Am Geriatr Soc 1990; 38:1290-1295

O'Connell JB, Bristow MR: Economic impact of heart failure in the United States: time for a different approach. J Heart Lung Transplant 1994; 13(suppl):S107-S112