Chronic heart failure in Japan: Implications of the CHART studies

Abstract

The prognosis of patients with chronic heart failure (CHF) still remains poor, despite the recent advances in medical and surgical treatment. Furthermore, CHF is a major public health problem in most industrialized countries where the elderly population is rapidly increasing. Although the prevalence and mortality of CHF used to be relatively low in Japan, the disorder has been markedly increasing due to the rapid aging of the society and the Westernization of lifestyle that facilitates the development of coronary artery disease. The Chronic Heart Failure Analysis and Registry in the Tohoku District (CHART)-1 study was one of the largest cohorts in Japan. The study has clarified the characteristics and prognosis of Japanese patients with CHF, demonstrating that their prognosis was similarly poor compared with those in Western countries. However, we still need evidence for the prevention and treatment of CHF based on the large cohort studies or randomized treatment trials in the Japanese population. Since the strategy for CHF management is now changing from treatment to prevention, a larger-size prospective cohort, called the CHART-2 study, has been initiated to evaluate the risk factors of CHF in Japan. This review summarizes the current status of CHF studies in Japan and discusses their future perspectives.

Keywords:

• heart failure
• aging
• Japanese

Acknowledgements

Active investigators of the CHART studies were described in the paper previously published (Shiba et al 2004) and at the website of the Tohoku Heart Failure Association (see http://tohoku.cardiovascular-medicine.jp). The CHART-1 study was supported by the research grants from the Ministry of Health, Labor and Welfare and Gonryo Medical Foundation. We are grateful for the assistance of research nurses who are working at the Tohoku Heart Failure Association; Mika Matsuki, Shizuka Osaki, Kiriko Yukishita, Yuuko Kidoguchi, Miho Hotta, Haruka Kohno, and Keiko Nishiura.