Rotterdam Study finds declining heart failure incidence across three decades

Researchers examined temporal changes in heart failure (HF) in the population-based Rotterdam Study across three epochs: 1989–1993 (7,983 participants), 1997–2001 (7,738), and 2009–2014 (6,170). Participants had a mean age of nearly 70 years. Analyses assessed baseline HF prevalence, incidence over five years, baseline comorbidities, and risk determinants using Cox proportional hazards models.

HF prevalence was 3.3%, 6.0%, and 4.8% across the respective epochs, representing an overall upward trend (p<0.001) despite a decline after the 2000s. Incidence fell from 16.3 per 1,000 person-years (95% CI 15.0–17.8) to 10.3 (9.2–11.4) and 7.9 (6.9–9.0). Hypertension was the most common comorbidity among participants with HF, followed by dyslipidemia and kidney dysfunction.

Associations of hypertension and diabetes with incident HF weakened over time, whereas coronary heart disease, atrial fibrillation, and stroke showed trends toward stronger associations. These findings describe changing risk patterns rather than establish their causes or justify reduced attention to hypertension or diabetes. Interpretation is limited to the available abstract: hazard ratios and details of model adjustment were not provided, and the older population may limit generalizability to younger adults.