Impact of non-cardiovascular comorbidities on the quality of life of patients with chronic heart failure: a scoping review

Abstract

Purpose To determine the impact of non-cardiovascular comorbidities on the health-related quality of life (HRQoL) of patients with chronic heart failure (CHF). Methods A scoping review of the scientific literature published between 2009 and 2019 was carried out. Observational studies which assessed the HRQoL of patients with CHF using validated questionnaires and its association with non-cardiovascular comorbidities were included. Results The search identified 1904 studies, of which 21 fulfilled the inclusion criteria to be included for analysis. HRQoL was measured through specific, generic, or both types of questionnaires in 72.2%, 16.7%, and 11.1% of the studies, respectively. The most common comorbidities studied were diabetes mellitus (12 studies), mental and behavioral disorders (8 studies), anemia and/or iron deficiency (7 studies), and respiratory diseases (6 studies). Across studies, 93 possible associations between non-cardiovascular comorbidities and HRQoL were tested, of which 21.5% regarded anemia or iron deficiency, 20.4% mental and behavioral disorders, 20.4% diabetes mellitus, and 14.0% respiratory diseases. Despite the large heterogeneity across studies, all 21 showed that the presence of a non-cardiovascular comorbidity had a negative impact on the HRQoL of patients with CHF. A statistically significant impact on worse HRQoL was found in 84.2% of associations between mental and behavioral disorders and HRQoL (patients with depression had up to 200% worse HRQoL than patients without depression); 73.7% of associations between diabetes mellitus and HRQoL (patients with diabetes mellitus had up to 21.8% worse HRQoL than patients without diabetes mellitus); 75% of associations between anemia and/or iron deficiency and HRQoL (patients with anemia and/or iron deficiency had up to 25.6% worse HRQoL than between patients without anemia and/or iron deficiency); and 61.5% of associations between respiratory diseases and HRQoL (patients with a respiratory disease had up to 21.3% worse HRQoL than patients without a respiratory disease). Conclusion The comprehensive management of patients with CHF should include the management of comorbidities which have been associated with a worse HRQoL, with special emphasis on anemia and iron deficiency, mental and behavioral disorders, diabetes mellitus, and respiratory diseases. An adequate control of these comorbidities may have a positive impact on the HRQoL of patients.

Factors Differentiating Rural and Urban Population in Determining Anxiety and Depression in Patients with Chronic Cardiovascular Disease: A Pilot Study

“…The characteristics presented here might constitute the basis for deeper research into the concepts, and shows a huge need for professional support. Comorbidities negatively impact the quality of life and disability in patients with chronic diseases [ 45 , 46 ]. The comprehensive management of patients with CVD should include the treatment of comorbidities that have been associated with a worse quality of life, with special emphasis on anxiety and depression disorders.…”

Early detection of anaemia in primary care with haemoglobinometry: ANHEMOG clinical trial protocol

“…7 Servei d' Atenció Primària Barcelonés Nord i Maresme, Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain. 8 Centre d' Atenció Primària La Riera (Mataró 1), Institut Català de la Salut, Barcelona, Spain. 9 Department of Medicine, Faculty of Medicine, Universitat de Girona, Girona, Spain.…”

“…In asymptomatic patients without cardiovascular risks, transfusion is rarely needed until Hb drops below 7-8 g/dl or haematocrit falls between 21 and 24%, although there are some clinical circumstances in which is not recommended to let Hb drop that low for an extended period, or the optimal transfusion strategy is unclear. For example, in patients with coronary artery disease, it has been found that a restrictive transfusion strategy (in most cases, with the limit at 9 mg/dl) is linked to a higher risk of experiencing another cardiac ischemic event, while a personalized, liberal transfusion strategy lowers that same risk [7][8][9][10][11], however, the observed results of a recent clinical trial suggests that there may be merit to a restrictive strategy [7].…”

“…Chronic anaemia can lead to multiple decompensations, not just as a result of the disease itself, but also due to its contribution to the adverse development of other chronic pathologies. The prevalence of anaemia in patients with heart failure (HF) is approximately 37% [8], although it can range from 9 to 69.6% depending on the patient's characteristics. Patients with HF and anaemia present greater cardiovascular risk and higher mortality [2,3,8].…”

“…The prevalence of anaemia in patients with heart failure (HF) is approximately 37% [8], although it can range from 9 to 69.6% depending on the patient's characteristics. Patients with HF and anaemia present greater cardiovascular risk and higher mortality [2,3,8]. Iron deficiency in patients with low ejection fraction is associated with decreased long-term survival and lower quality of life [9].…”