Editorial Trends in incidence and prognosis of heart failure You

This editorial refers to $Decreasing one-year mortality and hospitalization rates for heart failure in Sweden by M. Schaufelberger et al. on page 300† The last two decades of the 20th century saw a signifi-cant improvement in our understanding of the aeti-ology and pathophysiology of chronic heart failure (CHF), a disorder with a mortality rate higher than many soft tissue tumours.1 Multiple neurohumoral pathways, abnormalities of cardiac shape, size and electrical activation, have been shown to influence the natural history of CHF. Based on this understanding, randomized controlled trials established angiotensin converting enzyme inhibitors, and more recently beta-adrenoceptor blockers and spironolactone, as agents that can improve the morbidity and mortality of CHF