HF in Europe: a changing landscape

A large-scale survey on heart failure (HF) epidemiology in European Society of Cardiology (ESC) member countries revealed important developments in HF statistics, which are crucial for understanding the societal impact of HF and for providing insights into the capacities of healthcare systems.

The European HF survey collected data from 43 ESC member countries (representing a population of over 900 million individuals) to reveal European HF epidemiology trends and treatment reimbursement patterns across countries, and to evaluate activities of professional and patient organisations [1]. “The long-term mission is the surveillance of HF epidemiology and management capacities in ESC member countries,” added Dr Marija Polovina (University Clinical Centre of Serbia).

Compared with 2019 [2], the median incidence of HF per country appears to be rising (3.9 new cases per 1,000 person-years [PYs] vs 3.2 per 1,000 PYs) [3]. Similarly, the median prevalence in the total population may be higher in 2025 than in 2019 (1.9% vs 1.7%), and the number of hospitalisations appears to have increased (333 per 100,000 per year vs 267). “We also collected outcome statistics,” Dr Polovina continued. The median in-hospital all-cause mortality was 8.0% in the current survey, and the median 1-year all-cause mortality among patients with HF was 14.5%. Interestingly, there was no correlation between several HF outcomes and national income levels. “Another pattern that we observed is that the prevalence of HF mirrors the regional patterns of cardiovascular risk factors,” said Dr Polovina.

Notable advancements included expanded access to specialised HF centres and the increased availability of in-hospital biomarker testing. The median number of HF centres was 2.6 per 1,000,000 individuals. “Access to heart transplantation remains limited, and the use of short- and long-term mechanical circulatory support or ultrafiltration is still modest, largely influenced by socioeconomic factors. On a more positive note, we did see improved access to cardiac rehabilitation for patients with HF, both in-hospital and in outpatient settings,” stated Dr Polovina.

Dr Polovina mentioned that the public reimbursement of HF medications is significantly driven by socioeconomic factors, particularly for the novel agents. Across the spectrum, many drugs are only partially or conditionally reimbursed. “This is true for class I drugs and additional guideline-recommended medications, such as ivabradine and vericiguat,” clarified Dr Polovina.

In conclusion, the current survey revealed several emerging trends concerning the occurrence of HF, the professionalisation of healthcare centres, and the use of HF medication in ESC member countries. This data can help the community understand what is needed in the prevention, treatment, and systems-level management of HF across Europe.

1. Polovina M, et al. Europe: insights from the HFA Observe Survey. Heart failure epidemiology and management across the globe, Heart Failure 2025, 17 May, Belgrade, Serbia.
2. Seferovic PM, et al. Eur J Heart Fail. 2021;23(6):906-914.
3. Seferovic PM, et al. Eur J Heart Fail. 2025; accepted.

Medical writing support was provided by Dr Rachel Giles.

 

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Posted on 24 June 202526 June 2025