There are relatively few studies of individuals with CHF that begin surveillance with the onset of symptoms and continue longterm surveillance. All are characterized by high mortality within the first 1-5 years, regardless of age.

At 3 years of follow-up, 79.7% of the men aged 65 years and older studied in the 1950's by Bedford and Caird had died. The follow-up of CHF was started after the first hospital contact of the patient and not the first manifestations of the syndrome. However, for the vast majority of the patients, this was their first episode of CHF (personal communication, Francis I. Caird, 1990).

Sixty-two percent of the men and 42% of the women of all ages in the Framingham study had died 5 years after onset of symptoms of CHF, and as many as 20% of the men and 14% of the women died within the first year of diagnosis.

A recently completed study by Taffet, et al., which followed veterans 75 years and older after their first documented episode of CHF, highlights this trend in CHF survival analysis (first figure below). At the end of one year, 28% of the patients had died. Thereafter, the slope of the survival curve for patients with CHF did not differ significantly from that of a control group comprised of Texas males. Survival was essentially the same whether or not systolic ventricular function was impaired as determined by left ventricular ejection fraction (LVEF).

A plot of Taffet's data alongside data from Bedford's study (figure below) supports the earlier statement by Bedford and Caird, "If a patient survives the first year after coming under treatment (for CHF), his expectation of life will be at least equal to the normal."

The explanation for this return to normal longevity for patients surviving their initial year of CHF remains unknown. However, if these findings are confirmed, newly identified CHF patients who are beyond their first year of CHF may have missed the period of time in which treatment is most beneficial.