Prognostic Significance of Atrial Fibrillation in Acute Heart Failure Admissions: The New Zealand Heart Failure Registry

Abstract

Background: Australian studies have demonstrated that beta-blockers are under-prescribed and used at suboptimal doses in patients with chronic heart failure (CHF). In this study we estimated the prevalence of CHF and aspects of beta-blocker utilisation using data from BEACH -a continuous, national, cross-sectional study of general practice activity in Australia from April 2010 to March 2011 and a SAND sub-study that collected CHF data from 2952 general practice patients from November 2010 to January 2011.Results: The prevalence of CHF in Australia was estimated as 1.9% (95% CI: 1.4-2.4%). Of general practice encounters with patients with CHF, 75.4% of patients were aged ≥75 years. The proportions of male and female patients were 48.5% and 51.5%, respectively. The proportions of patients with NYHA grading Class I, II, III and IV were 28.3%, 47.5%, 20.0% and 2.5%, respectively.Of the 123 respondents with medication data in the sub-study, 118 (95.9%) were taking medication for CHF, including 74 (60.2%) taking a beta blocker. Of the 315 listed medications for CHF, 88 (27.9%) were diuretics and 74 (23.5%) were beta blockers. Of the beta blockers, 39 (52.7%) were specifically indicated for CHF, and 13 (17.6%) were at target dose. Thus only 4.1% of the listed medications were beta blockers indicated for CHF at target dose. The most common reasons for not using a beta blocker were advanced age (57.1%), diabetes (16.3%) and renal impairment (16.3%).Conclusion: This data highlights the suboptimal use of beta blockers in CHF patients in an Australian community setting.http://dx.