More adults have congenital heart disease-study

By Ed Stoddard

DALLAS (Reuters) - Severe cases of congenital heart disease are on the rise among North American adults, but researchers say this probably means more infants born with the condition are surviving into adulthood.

"This is a real success story," said Dr. Ariane Marelli, lead author of a new study on the trend and director of the McGill Adult Unit for Congenital Heart Disease Excellence at McGill University in Montreal.

The study, which analyzed databases in the Canadian province of Quebec where access to health care is universal, found that severe congenital heart disease had risen among adults by 85 percent from 1985 to 2000.

Among children the increase over the same time period was 22 percent, according to the study, published on Monday in Circulation: Journal of the American Heart Association.

Congenital heart defects, which occur before birth, are structural problems related to the abnormal formation of the heart or major blood vessels near the heart.

Marelli said increased survival rates for infants born with these defects were the most likely reason for the increased adult prevalence of severe CHD, but more research is needed to make the link definitive.

"There are many possible reasons for the increase," but the most likely is the advances in pediatric heart care that have allowed these infants to survive, she said.

"To our knowledge, this is the first study to measure the changing number of patients in a North American population during a period of major progress in the management of CHD," Marelli said.

"This is the largest population study of CHD to have been performed in North America. We have no reason to believe that the predominantly Caucasian population of Quebec and Canada is different from the United States," she said.

Extrapolating the study findings in Quebec to the U.S. population, researchers estimate that 1.8 million Americans had congenital heart disease in 2000, including 900,000 adults and 900,000 children, or 1 out of every 85 children and 1 out of every 250 adults.

"For comparison purposes, cystic fibrosis occurs in 1 of 4,500 live births, so there are 45 times more children with congenital heart disease than children with cystic fibrosis and most of these children are now becoming adults," Marelli said.

"The increasing prevalence of congenital heart disease means these children will live longer and acquire other forms of heart disease," Marelli said.