在西方国家,心力衰竭的患病率约为1%-2%,每年每千人约5-10人发病。[4]Mosterd A, Hoes AW. Clinical epidemiology of heart failure. Heart. 2007;93:1137-1146.http://www.ncbi.nlm.nih.gov/pubmed/17699180?tool=bestpractice.com在英国,充血性心力衰竭住院患者人数达到100万年住院床日,占所有急诊入院患者的5%。在未来25年,这些数字预计会升高50%。[5]National Collaborating Centre for Chronic Conditions. Chronic heart failure: national clinical guideline for diagnosis and management in primary and secondary care. July London, UK: Royal College of Physicians; 2003.2006年,澳大利亚进行的一项心脏研究发现6.3%的堪培拉人患有明确、有症状的心力衰竭,亚临床心力衰竭患者的比例更高。[6]Krum H, Stewart S. Chronic heart failure: time to recognize this major public health problem. Med J Australia. 2006;184:147-148.http://www.ncbi.nlm.nih.gov/pubmed/16489893?tool=bestpractice.com
在美国估计有500万心力衰竭患者,每年新增病例55万余。[7]Rosamond W, Flegal K, Friday G, et al. Heart disease and stroke statistics - 2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2007;115:e69-e171.http://www.ncbi.nlm.nih.gov/pubmed/17194875?tool=bestpractice.com[8]Thom T, Haase N, Rosamond W, et al. Heart disease and stroke statistics - 2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006;113:e85-e151.http://circ.ahajournals.org/content/113/6/e85.fullhttp://www.ncbi.nlm.nih.gov/pubmed/16407573?tool=bestpractice.com每年可导致 1200-1500 万次门诊就诊和 650 万个住院日。[9]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:S107-S112.http://www.ncbi.nlm.nih.gov/pubmed/7947865?tool=bestpractice.com[10]O'Connell JB. The economic burden of heart failure. Clin Cardiol. 2000;23:III6-III10.反复住院是影响生活质量和增加医疗花费的主要原因:例如,从1990年到1999年,初诊住院人数每年从约81万增加到100多万,初诊或复诊人数从240万增加到360万。[11]Koelling TM, Chen RS, Lubwama RN, et al. The expanding national burden of heart failure in the United States: the influence of heart failure in women. Am Heart J. 2004;147:74-78.http://www.ncbi.nlm.nih.gov/pubmed/14691422?tool=bestpractice.com心力衰竭患者尤其容易反复住院,据报告称,出院6个月内的再住院率高达50%。2001年,有近53000例患者死于心力衰竭(作为原发性病因)。虽然治疗水平不断提高,但是死亡人数还是在稳步上升,部分原因是由于心力衰竭的患者越来越多,这部分患者往往是由于早年患有急性心肌梗死,当时接受了较好的治疗降低了死亡率。心力衰竭是老年人的主要疾病之一,因而“人口老龄化”也是导致其发病率升高的原因。65岁以上人口心力衰竭的发病率接近10‰,在住院患者中约占80%。[2]Jessup M, Abraham WT, Casey DE, et al. 2009 focused update: ACCF/AHA guidelines for the diagnosis and management of heart failure in adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009;119:1997-2016.http://circ.ahajournals.org/cgi/content/full/119/14/1977http://www.ncbi.nlm.nih.gov/pubmed/19324967?tool=bestpractice.com