Heart failure in primary care: prevalence related to age and comorbidity

Abstract

Background Diagnosing heart failure (HF) in primary care can be challenging, especially in elderly patients with comorbidities. Insight in the prevalence, age, comorbidity and routine practice of diagnosing HF in general practice may improve the process of diagnosing HF. Aim To examine the prevalence of HF in relation to ageing and comorbidities, and routine practice of diagnosing HF in general practice. Methods A retrospective cohort study was performed using data from electronic health records of 56 320 adult patients of 11 general practices. HF patients were compared with patients without HF using descriptive analyses and χ2 tests. The following comorbidities were considered: chronic obstructive pulmonary disorder (COPD), diabetes mellitus (DM), hypertension, anaemia and renal function disorder (RFD). Separate analyses were performed for men and women. Findings The point prevalence of HF was 1.2% (95% confidence interval 1.13–1.33) and increased with each age category from 0.04% (18–44 years) to 20.9% (⩾85 years). All studied comorbidities were significantly (P<0.001) more common in HF patients than in patients without HF: COPD (24.1% versus 3.1%), DM (34.7% versus 6.5%), hypertension (52.7% versus 16.0%), anaemia (10.9% versus 2.3%) and RFD (61.8% versus 7.5%). N-terminal pro-BNP (NT-proBNP) was recorded in 38.1% of HF patients. Conclusions HF is highly associated with ageing and comorbidities. Diagnostic use of NT-proBNP in routine primary care seems underutilized. Instruction of GPs to determine NT-proBNP in patients suspected of HF is recommended, especially In elderly patients with comorbidities.

Heart failure epidemiology and treatment in primary care: a retrospective cross‐sectional study

“…In our study, the prevalence of HF among patients visiting a GP was 0.5%. This is low in comparison with other European database studies, where HF prevalence was 1.2–1.3% (Netherlands 21 and Italy 22 ). For Switzerland, HF prevalence has been estimated at 2.5% 23 .…”

Comparison of Household Income In In-Hospital Outcomes After Implantation of Left Ventricular Assist Device

“…Diseases of affluence primarily reflect chronic non-communicable ailments including, but not limited to: cancer, degenerative autoimmune diseases, chronic lung diseases, type 2 diabetes mellitus, and hypertension (20). These comorbidities and their chronic progression are risk factors for cardiovascular disease, providing a rudimentary explanation for heart failure and the need for advanced cardiac intervention at a later point in the lives of wealthy individuals (3,21).…”

Comparison of household income in in-hospital outcomes after implantation of left ventricular assist device

“…20 These comorbidities and their chronic progression are risk factors for cardiovascular disease, providing a rudimentary explanation for heart failure and the need for advanced cardiac intervention at a later point in the lives of wealthy individuals. 3,21 When differentiating between patients eligible for transplantation versus alternative therapies, many patients with significant comorbidities are deemed ineligible for transplantation, leaving LVADs as one of the few advanced therapy options available. 17 Previous studies indicate that individuals are more willing to receive an LVAD as the severity of their disease worsens and as their health-related quality of life diminishes.…”