Dying from cardiovascular disease: An epidemiologic perspective

Abstract

While cardiovascular disease is widely recognized as a leading cause of death, end of life care for patients dying from cardiovascular disease remains incompletely embraced. Heart failure is a common final pathway for many such patients; its incidence is increasing as are the costs associated with it. A significant proportion of the costs associated with congestive heart failure are incurred in the last months of life, and may be related to overly aggressive care in patients with an irreversibly poor prognosis. Many factors contribute to the poor uptake of palliative and hospice care. Chief amongst these is the difficulty in establishing prognosis and predicting death among patients with cardiovascular disease. It has been suggested that novel models of palliation may be needed given these challenges.