Congestive heart failure life expectancy: overview
Congestive heart failure or CHF is not exactly failure of the heart. Despite the name “heart failure”, it does not mean complete failure of the heart. When we talk about heart failure, we are talking about failure in the effective pumping of the heart. Your heart is basically a pump. When that pump gets less efficient in keeping your blood circulated, we call it pump failure or heart failure. Despite the name, you do not die instantly from heart failure. The recent advances in treatment of heart failure has significantly improved life expectancy of people living with heart failure but the actual numbers are still not very encouraging.
Congestive heart failure life expectancy in numbers:
Despite the overall better care and improved prognosis, life expectancy of people already diagnosed with heart failure remains somewhat worrisome when we look at the long term numbers.
Based on data obtained in the late 1990s, here are the mortality and life expectancy numbers of men and women. They first looked at 1 month and 1 year mortality rate:
- 11% of men died within one month of diagnosis of heart failure
- 10% of women died within one month of diagnosis of heart failure
- 28% of men died within one year of diagnosis of heart failure
- 24% of women dies within one year of diagnosis of heart failure
Looking at the survivors, they calculated five year mortality and life expectancy as follows:
- 59% of men died within 5 years of diagnosis of heart failure
- 45% of women died within 5 years of diagnosis of heart failure
From these numbers, we can see that congestive heart failure life expectancy varies widely in different people. Since then, scientists have looked at many different factors to try to estimate congestive heart failure life expectancy in different groups of patient. Several institutions have even started calculating it for individual patients by putting their individual data in the system. It will not be possible to explore such sophisticated systems here. However, several specific points about life expectancy and survival from heart failure deserve closer look.
- Hospital admission adversely affects congestive heart failure life expectancy
It appears like being sick enough to require hospitalization is an indicator of poor prognosis. After a hospital stay, one month survival rate goes down. However, if the patient improves enough to stay away from hospital, the survival rate slowly improves and goes back to baseline. - Medication compliance has positive effect on congestive heart failure life expectancy
Patients who stick to their medical regimen seem to have better prognosis than who do not. - Congestive heart failure life expectancy depends on the functional stage of the disease
4 Classes of congestive heart failure :
Here are the the all 4 stages of heart failure classified based on the functional level of the patient. This classification system is also called New York Heart Association functional classification.
- Class I : Basically, these patients have no symptoms of heart failure. They feel OK with all normal physical activity and do not run out of breath with activity. They do not have any functional limitations. Patients in this class have the best life expectancy.
- Class II: These patients are just starting to feel some symptoms of heart failure. These patients feel OK at rest but have some symptoms with physical exertion. They may run out of breath walking at a faster pace or climbing stairs. They usually feel OK with they take their time and limit their activity. These patients do not have any symptoms at rest.
- Class III: These patients run out of breath with minimal activity. They may huff and puff just walking at a normal pace. They usually have to significantly lower their physical activity in order to feel comfortable with their breathing. They still do not have any symptoms at rest.
- Class IV: These patients have symptoms at rest. They are unable to engage in any physical activity without significant worsening of their symptoms. Patients in this class have the worst life expectancy.
Past studies have shown that patients with Class IV and Class III NYHA heart failure symptoms have significantly reduced life expectancy than people with Class II symptoms. Patients with Class IV symptoms were 4.1 times less likely to survive as compared to patients with Class II symptoms. Similarly, patients with Class III symptoms were 2.1 times less likely to survive compared to patients with Class II symptoms.
Congestive heart failure life expectancy in elderly patients with advanced heart failure:
This is the group of patients who have the worst life expectancy among all heart failure patients. Many elderly patients with advanced heart failure have life expectancy of less than a year. There are some invasive and aggressive treatment modalities that can increase the survival rate but those treatment can have major complications resulting in significant suffering. If your elderly parent or grandparent is suffering from advanced heart failure, you need to get your family together to discuss the goals of care. Some elderly heart failure patients do not want these aggressive invasive treatment and want to be as comfortable as possible and spend quality time at home with their loved ones. Some patients may want to accept the risk of complications and opt for invasive treatment in hope of prolonging their lives. It is important to have this discussion before it is too late. When many elderly people get admitted to the hospital with severe symptoms of advanced heart failure, their family tend to make emotional decision that may or may not be in accordance with the patients’ values. You can avoid this situation by having a clear discussion well before it gets to that stage.
Congestive heart failure life expectancy in young patients
Most of the studies done about life expectancy in heart failure patients included older patients. It was not clear what to expect in young patients with heart failure. It was assumed that younger patients with heart failure would have better life expectancy than their older counterparts. A few studies in the last 15 years have looked at this and they did find a difference in life expectancy in young people vs older people with similar stages of heart failure. However, this difference was somewhat less than what they expected. They also noted that many young people had harder time complying with the recommended treatment compared to their older counterparts. Many young patients in the study did not follow the recommended diet and did not take their medications as religiously as the older patients did.
Although the exact life expectancy of young people with heart failure who comply with all recommended treatment is unclear, it is assumed that they would do much better. Young people also better tolerate invasive procedures and heart surgeries if required. Treatment guidelines for heart failures have been evolving and getting better every year. With the amount of research being done currently, young patients can hope to get even better care in the future that may significantly increase their life expectancy.