An epidemic of heart failure? Recent evidence from Europe.

Recent evidence from studies based in the general population, general practice and hospital strongly suggest that an epidemic of heart failure is emerging in Europe. Notably, a further increase in the prevalence of the syndrome in the elderly is expected in the next decades. Importantly, current population-based studies suggest that the majority of men and women with left ventricular systolic dysfunction is asymptomatic. This finding, together with the beneficial effect of angiotensin-converting enzyme inhibition in these patients reported in randomized trials, will further fuel discussions regarding the potential of echocardiographic screening of large populations or high-risk patients. Moreover, the potential additive value of echocardiographic or neurohumoral assessments in general practice remains to be established. More clinical epidemiological studies are needed to facilitate optimization of diagnosing various stages of heart failure, as well as asymptomatic ventricular dysfunction.