Frequent non-cardiac comorbidities in patients with chronic heart failure

Abstract

Heart failure (HF) in elderly patients is associated with more diffuse symptoms and signs due to the presence of other noncardiac comorbidities. This can cause difficulties in assessing the correct diagnosis and initiating appropriate therapy. The four most frequently occurring noncardiac comorbidities and therapies used to treat them are discussed in the present paper.Hypertension is an important precursor of HF, and is still the most common risk factor for HF in the general population. About 50% of patients with untreated hypertension will develop HF. Pressure overload leads to the development of left ventricular hypertrophy (LVH) and diastolic dysfunction.Diabetes, which occurs in about 20-30% of patients with HF, is an important comorbidity resulting in morphological and metabolic disturbances affecting myocardial blood flow and hormonal regulation leading to a poor outcome and necessitating aggressive conventional treatment.Chronic obstructive pulmonary disease (COPD), occurs in approximately 20-30% of heart failure patients, and may complicate HF treatment, it is therefore important to recognize and treat it effectively.Finally, the early detection of anemia, which occurs in 20-30% of HF patients, is important since it is associated with functional impairment and increased mortality and morbidity. Combined treatment with erythropoietin and intravenous iron has shown beneficial effects on clinical symptoms and morbidity.In conclusion early detection of concomitant diseases in patients with HF is important and should be considered carefully when initiating therapy.

TNF-α inhibitors in asthma and COPD: We must not throw the baby out with the bath water

“…In particular, there have been reports of etanercept-induced CHF [88]. This event appears to be very rare, but therapy with etanercept for patients with unstable cardiac disease might be best avoided.…”

“…This event appears to be very rare, but therapy with etanercept for patients with unstable cardiac disease might be best avoided. This is a problem in COPD patients because the prevalence of CHF in patients with COPD is known to range from 20% to 32% [88].…”

Pharmacological modulation of β-adrenoceptor function in patients with coexisting chronic obstructive pulmonary disease and chronic heart failure

“…The prevalence of chronic heart failure (CHF) in patients with chronic obstructive pulmonary disease (COPD) is known to range from 20% to 32% [1][2][3][4][5][6][7]. This high prevalence of CHF in patients with COPD is not surprising, because COPD and CHF share smoking as a common risk factor, and, moreover, it is likely that low-grade systemic inflammation accelerates progression of coronary atherosclerosis, which ultimately results in ischemic cardiomyopathy [8].…”

Demographical and clinicopathological characteristics in heart failure and outcome predictors: a prospective, observational study

“…It is in fact very difficult to determine which variable is prognostically most important to predict individual patient outcomes in HF. Established risk factors for the development of HF in men and women include age, CAD, hypertension, diabetes, obesity, and smoking9, 10, 11 apart from other prognostic variables which are the area of intense ongoing research 12. The subjects involved in our study also had similar risk factor profile.…”