Change in Comorbidity Prevalence with Advancing Age Among Persons with Heart Failure

Ahluwalia, Sangeeta C.; Gross, Cary P.; Chaudhry, Sarwat I.; Leo‐Summers, Linda; Ness, Peter H. Van; Fried, Terri R.

doi:10.1007/s11606-011-1725-6

Cited by 75 publications

(53 citation statements)

References 42 publications

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“…[8][9][10][11] Medicare beneficiaries with HF see 15 to 23 different providers annually in both the inpatient and outpatient settings, which could in turn increase the number of prescription medications prescribed. 6 As the number of prescription medications increases, so does the potential for adverse drug events and drug-drug interactions.…”

mentioning

confidence: 99%

Drugs That May Cause or Exacerbate Heart Failure

Page¹,

O’Bryant²,

Cheng³

et al. 2016

Circulation

328

185

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Heart failure is a common, costly, and debilitating syndrome that is associated with a highly complex drug regimen, a large number of comorbidities, and a large and often disparate number of healthcare providers. All of these factors conspire to increase the risk of heart failure exacerbation by direct myocardial toxicity, drug-drug interactions, or both. This scientific statement is designed to serve as a comprehensive and accessible source of drugs that may cause or exacerbate heart failure to assist healthcare providers in improving the quality of care for these patients.

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mentioning

confidence: 99%

Drugs That May Cause or Exacerbate Heart Failure

Page¹,

O’Bryant²,

Cheng³

et al. 2016

Circulation

328

185

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“…The dependent variable in the multivariate analysis was the diagnosis of the comorbidity. We selected as independent (explanatory) variables those variables with a previously reported association in the medical literature (age [17] , gender [5] , severity of COPD [5, Golpe et al , and clinical phenotype [6] ) or with biological plausibility of an association (frequent COPD exacerbations and the type of smoke exposure, which was the basis for the working hypothesis). Age was coded in 1-year increments.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Major Comorbidities in Chronic Obstructive Pulmonary Disease Caused by Biomass Smoke or Tobacco

Golpe

Martín-Robles²,

Sanjuán-López³

et al. 2017

Respiration

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Background: Comorbidities are very common in chronic obstructive pulmonary disease (COPD), contributing to the overall severity of the disease. The relative prevalence of comorbidities in COPD caused by biomass smoke (B-COPD), compared with COPD related to tobacco (T-COPD), is not well known. Objectives: To establish if both types of COPD are associated with a different risk for several major comorbidities. Method: The prevalence of comorbidities was compared in 863 subjects with B-COPD (n = 179, 20.7%) or T-COPD (n = 684, 79.2%). Multivariate analysis was carried out to explore the independent relationship between comorbidities and type of exposure. Results: Three comorbidities were more frequent in T-COPD than in B-COPD: ischemic heart disease (11.5 vs. 5.0%, respectively, p = 0.01), peripheral vascular disease (9.2 vs. 2.7%, p = 0.006), and peptic ulcer disease (4.8% vs. 0, p = 0.005). After correcting for potential confounding variables, the risk of ischemic heart disease was lower in B-COPD than in T-COPD (OR: 0.33, 95% CI: 0.16-0.69, p = 0.003). Conclusions: The prevalence of ischemic heart disease is significantly lower in B-COPD than in T-COPD, suggesting a different systemic effect of both types of smoke in COPD patients.

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“…254 These patients often are frail with significant comorbidity burden, mobility and cognitive impairments, and inadequate home support. [4][5][6] Opportunities exist to improve assessment and management of HF in SNFs. These efforts require organized SNF staff education and may include collaboration with community-or hospital-based HF experts.…”

Section: Discussionmentioning

confidence: 99%

“…36 Although ≈20% of SNF residents have a diagnosis of HF, almost 70% of a Medicare sample with a diagnosis of HF had ≥3 noncardiac comorbidities, and 40% had ≥5. 4,[36][37][38] Frailty strongly correlates with HF. 39,40 Frailty also confounds patient assessment and tolerance of medical therapies and increases mortality.…”

Section: Table 1 Classification Of Recommendations and Level Of Evidmentioning

confidence: 99%

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Heart Failure Management in Skilled Nursing Facilities

Jurgens¹,

Goodlin²,

Dolansky³

et al. 2015

Circ: Heart Failure

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655H eart failure (HF) is a complex syndrome in which structural or functional cardiac abnormalities impair the filling of ventricles or left ventricular ejection of blood. HF disproportionately occurs in those ≥65 years of age.1 Among the estimated 1.5 to 2 million residents in skilled nursing facilities (SNFs) in the United States, cardiovascular disease is the largest diagnostic category, and HF is common. 2,3Despite the high prevalence of HF in SNF residents, none of the large randomized clinical trials of HF therapy included SNF residents, and very few included patients >80 years of age with complex comorbidities.Several issues make it important to address HF care in SNFs. The healthcare environment and characteristics of SNF residents are distinct from those of community-dwelling adults. Comorbid illness unrelated to HF (eg, dementia, hip fracture) increases with age >75 years, and these conditions may complicate both the initial HF diagnosis and ongoing management. [4][5][6] Morbidity and mortality rates are significantly increased for hospitalized older adults with HF discharged to SNFs compared with those discharged to other sites. 7Transitions between hospitals and SNFs may be problematic. 8SNF 30-day rehospitalization rates for HF range from 27% to 43%, 7,9,10 and long-term care residents sent to the emergency department are at increased risk for hospital admission and death.11 The purpose of this scientific statement is to provide guidance for management of HF in SNFs to improve patientcentered outcomes and reduce hospitalizations. This statement addresses unique issues of SNF care and adapts HF guidelines and other recommendations to this setting. MethodsThis scientific statement on HF management in SNFs was developed by a writing group of experts representing nursing, medicine (cardiology, geriatrics, nursing home physicians, and palliative medicine), pharmacology, physical therapy, dietary clinical management, research, and quality of care. Sponsors (the American Heart Association [AHA] and the Heart Failure Society of America) identified specific members of the writing group, and others were selected on the basis of known expertise. A literature search was performed using the key The current document is solely the responsibility of the authors and does not represent the official views of the National Heart, Lung, and Blood Institute or the Department of Health and Human Services.The American Heart Association and the Heart Failure Society of America make every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This document was approved by the American Heart Association Science Advisory and Coordinating Committee on September 15, 2014, and by the...

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Change in Comorbidity Prevalence with Advancing Age Among Persons with Heart Failure

Cited by 75 publications

References 42 publications

Drugs That May Cause or Exacerbate Heart Failure

Drugs That May Cause or Exacerbate Heart Failure

Prevalence of Major Comorbidities in Chronic Obstructive Pulmonary Disease Caused by Biomass Smoke or Tobacco

Heart Failure Management in Skilled Nursing Facilities

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