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

Bosch, Lieke; Assmann, Patricia E.; Grauw, Wim J C de; Schalk, Bianca; Biermans, Marion C J

doi:10.1017/s1463423618000889

Cited by 33 publications

(27 citation statements)

References 18 publications

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“…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 .…”

Section: Discussioncontrasting

confidence: 76%

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

et al. 2020

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Aims Heart failure is one of the leading causes of morbidity and mortality worldwide, but little is known on heart failure epidemiology and treatment in primary care. This study described patients with heart failure treated by general practitioners, with focus on drug prescriptions and especially on the only specific treatment for heart failure with reduced ejection fraction, namely sacubitril/valsartan. Methods and results This was a retrospective cross‐sectional study using data from an electronic medical record database of Swiss general practitioners from 2016 to 2019. Multilevel logistic regression was used to find determinants of sacubitril/valsartan prescription; odds ratios (ORs) and 95% confidence intervals (CIs) were reported. We identified 1288 heart failure patients (48.5% women; age: median 85 years, interquartile range 77–90 years) by means of diagnosis code, representing 0.5% of patients consulting a general practitioner during the observation period. About 73.6% received a renin–angiotensin–aldosterone system inhibitor, 67.8% a beta‐blocker, 34.6% a calcium channel blocker, 86.1% a diuretic, and 40.1% another cardiac drug. Sacubitril/valsartan was prescribed in 6% predominantly male patients (OR 2.10, CI 1.25–3.84), of younger age (OR 0.59 per increase in 10 years, CI 0.49–0.71), with diabetes mellitus (OR 1.76, CI 1.07–2.90). The recommended starting dose for sacubitril/valsartan was achieved in 67.1% and the target dose in 28.6% of patients. Conclusions Prevalence of heart failure among patients treated by general practitioners was low. Considering the disease burden and association with multimorbidity, awareness of heart failure in primary care should be increased, with the aim to optimize heart failure therapy.

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Section: Discussioncontrasting

confidence: 76%

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

et al. 2020

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“…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).…”

Section: Discussionmentioning

confidence: 99%

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

Ebner

Karetnick

Grant³

et al. 2021

Preprint

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Introduction: Due to the inability to keep up with the demand for heart transplantation, there is an increased utilization of left ventricular assist devices (LVAD). However, paucity of data exists regarding the association of household income with in-hospital outcomes after LVAD implantation. Methods: Retrospective cohort study using the NIS to identify all patients ≥18 years who underwent LVAD implantation from 2011-2017. Statistical analysis was performed comparing low household income (≤50th percentile) and high income (>50th percentile). Results: A total of 25,503 patients underwent LVAD implantation. The low-income group represented 53% and the high-income group corresponded to 47% of the entire cohort. The low-income group was found to be younger (mean age 55 ±14 vs. 58 ±14 years), higher proportion of females (24% vs. 22%), and higher proportion of blacks (32% vs. 16%, p<0.001 for all). The low-income group was found to have higher prevalence of hypertension, chronic pulmonary disease, smoking, dyslipidemia, obesity and pulmonary hypertension (p<0.001 for all). However, the high-income cohort had higher rate of atrial tachyarrhythmias and end-stage renal disease (p<0.001). During hospitalization, patients in the high-income group had increased rates of ischemic stroke, acute kidney injury, acute coronary syndrome, bleeding and need of extracorporeal membrane oxygenation (p<0.001 for all). We found that the unadjusted mortality had an OR 1.30 (CI [1.21-1.41], p<0.001) and adjusted mortality of OR 1.14 (CI [1.05-1.23], p=0.002). Conclusion: In patients undergoing LVAD implantation nationwide, low-income was associated with increased comorbidity burden, younger age, and fewer in-hospital complications and all-cause mortality.

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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Introduction: Due to the inability to keep up with the demand for heart transplantation, there is an increased utilization of left ventricular assist devices (LVAD). However, paucity of data exists regarding the association of household income with in-hospital outcomes after LVAD implantation. Methods: Retrospective cohort study using the NIS to identify all patients ⩾18 years who underwent LVAD implantation from 2011 to 2017. Statistical analysis was performed comparing low household income (⩽50th percentile) and high income (>50th percentile). Results: A total of 25,503 patients underwent LVAD implantation. The low-income group represented 53% and the high-income group corresponded to 47% of the entire cohort. The low-income group was found to be younger (mean age 55 ± 14 vs 58 ± 14 years), higher proportion of females (24% vs 22%), and higher proportion of blacks (32% vs 16%, p < 0.001 for all). The low-income group was found to have higher prevalence of hypertension, chronic pulmonary disease, smoking, dyslipidemia, obesity, and pulmonary hypertension ( p < 0.001 for all). However, the high-income cohort had higher rate of atrial tachyarrhythmias and end-stage renal disease ( p < 0.001). During hospitalization, patients in the high-income group had increased rates of ischemic stroke, acute kidney injury, acute coronary syndrome, bleeding, and need of extracorporeal membrane oxygenation ( p < 0.001 for all). We found that the unadjusted mortality had an OR 1.30 (CI 1.21–1.41, p < 0.001) and adjusted mortality of OR 1.14 (CI 1.05–1.23, p = 0.002). Conclusion: In patients undergoing LVAD implantation nationwide, low-income was associated with increased comorbidity burden, younger age, and fewer in-hospital complications and all-cause mortality.

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

Cited by 33 publications

References 18 publications

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

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

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

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

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