Global heart failure rates and erythropoietin

Global variation in heart failure (HF) prevalence and mortality rates is evident and multiple factors have been hypothesised to explain such non-random distribution. The author hypothesised that this non-random HF distribution could be attributed, in part, to individual variation in the level of erythropoietin (EPO), a hormone and a possible cardioprotectant. Such individual EPO variation can be explained by hypoxia resulting from regional differences in geographic elevation. This hypothesis was justified using results from various animal-based and clinical studies. In addition, data from the population-based Healthcare Cost and Utilization Project was used. The global distribution of HF can be explained, in part, by the geographic landscape. Prospective studies based on the author’s hypothesis may provide new treatment opportunities for such an important health issue as HF. In addition, this hypothesis may demonstrate new insights into the mechanism of HF.

Graphical abstractFigure optionsDownload full-size imageDownload as PowerPoint slideHighlights▸ Global variation in heart failure (HF) mortality rates is evident. ▸ Erythropoietin (EPO) has some cardioprotective properties. ▸ The release of EPO is stimulated by hypoxia. ▸ Hypoxia is caused by higher geographic elevation. ▸ Geographic landscape may help to explain epidemiology of HF.