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Commentary
December 13/27, 1999

The Economics of Therapeutic AdvancesThe Paradigm of Sympathetic Suppression in Chronic Heart Failure

Arch Intern Med. 1999;159(22):2634-2636. doi:10.1001/archinte.159.22.2634

THE IMPACT of a newly introduced therapeutic approach is mostly determined by 2 facts: (1) it addresses a common condition that affects large numbers of people and defines their functional status and quality of life for long periods of time; (2) it is inexpensive and readily available not only to those who live in technologically advanced societies, but also to those who live in the developing countries, where most of the world's population resides. While death rates from other cardiovascular diseases are decreasing, the incidence of death rates from heart failure has been increasing in recent years. Several factors account for this trend, including, ironically, the successful management of inflammatory or ischemic heart disease, hypertension, and other conditions that lead to heart failure, as well as increasing life expectancy. Indeed, today, heart failure is estimated to affect about 5 million people in the United States, of whom more than 75% are older than 65 years.1 Similar trends are observed worldwide, partly as a result of successful implementation of various health measures and better living standards, which ensure that the incidence and prevalence of cardiovascular disease will continue to increase in aging populations.

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