HEART FAILURE (HF) is a major and escalating health problem in the United States and other industrialized societies, particularly those with aging populations. It is estimated that HF contributes to nearly 250 000 deaths annually in the United States, and this clinical syndrome is the principal cause of hospital admissions in the elderly; HF was listed as the primary discharge diagnosis for approximately 681 000 hospitalizations in persons aged 65 years and older in 1993.1,2 National estimates in 1990 suggest that more than 3 million Americans had HF, including nearly 1.8 million women and 1.5 million men.1
Reflecting the ever-increasing clinical and public health burden from this condition, the number of hospital discharges associated with HF in the United States has increased dramatically over time. The number of hospital discharges in which HF was the first listed diagnosis in 1993 (more than 875 000 admissions) was almost 5
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