- Background The burden of illness of heart failure (HF) may be changing. We performed a study to define temporal trends in hospital admissions and long-term mortality among patients admitted with acute decompensated heart failure. Methods We studied consecutive admissions with HF as a primary diagnosis at seven hospitals from 2000 to 2004. Admissions with a concurrent acute myocardial infarction were excluded from the analysis. Temporal trends in the etiology of HF, associated co-morbid conditions, medications and mortality were identified. Results A total of 21,581 hospitalizations of 12,769 patients with primary diagnosis of HF were studied (average age 75). Monthly admission rate decreased by 10% over the study period, primarily due to a decrease in HF admissions of IHD etiology. Between 2000 and 2004 there was a significant increase in post-discharge purchase of beta-blockers (from 44.0% to 69.0%, p Conclusions The admission of acute HF patients of IHD, but not non-IHD etiology declined throughout the study period. Short term mortality remained stable throughout the study period, while there was a significant improvement in 18month mortality rates. This reduction can be explained by higher utilization of the health services as can be manifested by an increase in statins and beta-blockers use.