Burden of heart failure in Kazakhstan: data from the unified national healthcare system 2014-2021

BACKGROUND: Heart failure (HF) affected 64.3 million people worldwide and contributed to 9.9 million years lived with disability globally in 2017. Despite its global relevance, there is a lack of comprehensive statistics on the prevalence, incidence, and burden of HF in developing Central Asian countries. This study aims to fill the gap and present the data for Kazakhstan, the largest Central Asian country. METHODS: HF cases were identified through the Unified National Electronic Healthcare System records for 2014-2021 using the appropriate ICD-10 codes. Descriptive and survival analyses were used to present demographics, incidence, prevalence, and mortality rates. The calculation of DALYs is done according to the WHO methods. The information on comorbid conditions based on respective ICD-10 codes was collected by merging the databases using unique deidentifying patient numbers. RESULTS: During the observation period between 2014-2021 years, 501,663 patients with HF were identified, of them 52% were females, 86% were older than 50 years of age, and 58% were of Kazakh ethnicity. Hypertension, history of cerebrovascular diseases, and myocardial infarction were present in 40%, 34%, and 22% of the cohort, respectively. The age and sex-specific incidence show that women have higher incidence before 30 years of age compared to men. In addition, incidence rates for both sexes and all age categories decreased in 2021 compared to 2014. The prevalence dramatically increased from 4393 people per million population (PMP) to 22,088 PMP, while mortality rates changed from 367 to 721 PMP during the observation period. In 2021, 2,964,062 age and disability-adjusted life years (DALYs) were lost due to HF in Kazakhstan. More than 2 million DALYs belong to years of life lost (YLLs). CONCLUSIONS: The DALYs show high economic and social loss due to high mortality among patients. Healthcare policymakers should prioritize the enhancement of cardiac services and the mitigation of its risk factors. KEY MESSAGES: • This study highlights the high burden of heart failure in Kazakhstan, with over 2 million DALYs lost in 2021 alone. Healthcare policymakers must prioritize cardiac services and risk factor reduction. • Lack of comprehensive data on HF in Central Asia made it difficult to tackle the burden. This study fills this gap, presenting valuable information for policymakers to reduce social and economic loss.