Heart Failure Trends and Mortality in India

February 10, 2025

India’s heart failure landscape presents alarming statistics. Recent findings reveal that heart failure patients in India are nearly a decade younger than those in high-income countries. The National Heart Failure Registry (NHFR) indicates a one-year mortality rate of 25%, with variations based on the underlying cause of heart failure.

About Heart Failure

Heart failure occurs when the heart cannot pump sufficient blood to meet the body’s needs.
It is a critical health issue globally.
In India, heart failure affects younger populations, denoting a growing health concern.

National Heart Failure Registry (NHFR)

The NHFR is India’s first nationally representative heart failure registry.
It enrolled 10,850 patients from 53 centres across 24 states and two union territories.
The Sree Chitra Tirunal Institute for Medical Sciences and Technology coordinates this multicentric study.
The registry aims to inform policies to reduce heart failure-related mortality.

Causes of Heart Failure

Ischemic heart disease is the leading cause, affecting 71.9% of patients.
Dilated cardiomyopathy follows at 17.3%, while rheumatic heart disease accounts for 5.4%.
Other causes include non-rheumatic valvular heart disease, congenital heart disease, and infective endocarditis.

Mortality Rates

The one-year mortality rate for heart failure patients is alarmingly high.
Ischemic heart disease has a mortality rate of 21.1%, while dilated cardiomyopathy is at 23.7%.
Rheumatic heart disease shows an even higher mortality rate of 27.5%.
Infective endocarditis has the highest mortality at 50%.

Factors Influencing Mortality

Timely management of ischemic heart disease contributes to better survival rates.
Non-compliance with medication and poor lifestyle choices increase mortality risks.
The NHFR marks the need for improved awareness and treatment options, especially in low- and middle-income countries.

Gender Disparities

Women represent one-third of heart failure patients.
They are more affected by rheumatic and congenital heart diseases.
The proportion of women increases in these categories, indicating a need for targeted interventions.

Implications for Low- and Middle-Income Countries

The NHFR findings underline the high mortality rates associated with rheumatic and congenital heart diseases in India.
Lack of awareness about acute rheumatic fever and inadequate treatment options exacerbate the situation.
Timely surgical interventions are critical for improving outcomes.

Future Directions

Addressing the high mortality rates associated with heart failure requires comprehensive strategies. These include enhancing disease management, increasing awareness, and ensuring timely medical interventions.

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