Spectrum of heart failure in older patients: Results from the national heart failure project

Havranek, Edward P.; Masoudi, Frederick A.; Westfall, Kelly A.; Wolfe, Pam; Ordin, Diana L.; Krumholz, Harlan M.

doi:10.1067/mhj.2002.120773

Cited by 242 publications

(164 citation statements)

References 10 publications

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“…In contrast, among the general Medicare population, it has been estimated that only 7.6% have ≥3 conditions overall 19 . Our estimates of comorbidity prevalence across age strata are also consistent with existing data; for example, findings from the National Heart Failure Project (NHFP) indicated that diabetes and COPD were more prevalent among adults aged 65-74, while stroke and dementia were more prevalent among adults aged 86 years and over 20 . While the NHFP examined the cross-sectional prevalence of a small set of comorbidities, the current study provides a more comprehensive evaluation of comorbidity by examining the change in prevalence of a broad range of comorbidities over time.…”

Section: Discussionsupporting

confidence: 87%

“…The use of administrative data sources for estimating the prevalence of conditions is at risk for underestimating the true burden of disease 38 ; however, we believe that our use of the CCW, designed specifically to mitigate the risk of underestimation through the use of evidence-based algorithms to indicate the presence of a disease, facilitated the accurate reporting of disease prevalence. Moreover, a prior study that utilized chart review methods to identify comorbid conditions among older adults with heart failure resulted in similar prevalence estimates 20 , providing support for the CCW algorithms as an alternative to more costly and time-consuming methods for identifying comorbidity. Future and ongoing evaluation of the accuracy of CCW-defined conditions will be important in determining the full utility of this data source.…”

Section: Discussionmentioning

confidence: 81%

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Change in Comorbidity Prevalence with Advancing Age Among Persons with Heart Failure

et al. 2011

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BACKGROUND: Comorbidity-a condition that co-exists with a primary illness-is common among older persons with heart failure and can complicate the overall management of this population. OBJECTIVES: To determine the relationship between advancing age and the prevalence and patterns of comorbidity among older persons with heart failure. DESIGN: Retrospective longitudinal cohort study PARTICIPANTS: A total of 201,130 Medicare beneficiaries with heart failure stratified into three age strata in 2001: 66-75, 76-85, and 86+ years, and followed over 5 years. MEASUREMENTS: (1) Prevalence of 19 conditions as identified by the Chronic Conditions Warehouse fromMedicare claims data, characterized as concordant (related to heart failure) or discordant (unrelated to heart failure), and (2) overall comorbidity burden, defined as count of conditions. RESULTS: The median number of comorbidities rose from four (IQR: 2-5) to five (IQR: 4-7) among the youngold, and from 4 (IQR: 3-6) to 6 (IQR: 5-8) among the middle-old and oldest-old between 2001 and 2006. In 2001, the majority of concordant conditions were more prevalent among the youngest than oldest beneficiaries (e.g., diabetes 46.2% vs 26.9%; kidney disease 21.8% vs 18.4%), while the majority of discordant conditions were more prevalent among the oldest-old than youngest-old beneficiaries (e.g., dementia 39.6% vs 9.9%; hip fracture 9.5% vs 1.9%). Discordant conditions increased in prevalence faster among the oldest than youngest beneficiaries (e.g., dementia 13% points versus 9% points). CONCLUSION: Among older Medicare beneficiaries with heart failure, there is a higher overall burden of comorbidity and greater prevalence of discordant comorbidity among the oldest old. Comorbidity prevalence increases over time, with discordant comorbidity increasing at the fastest rate among the oldest old. This comorbidity burden highlights the challenge of effectively treating heart failure while simultaneously managing co-existing and unrelated conditions.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 81%

Change in Comorbidity Prevalence with Advancing Age Among Persons with Heart Failure

et al. 2011

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“…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].…”

Section: Introductionmentioning

confidence: 99%

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

Matera

Martuscelli

Cazzola

2010

Pulmonary Pharmacology & Therapeutics

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“…An important factor in both the prognosis and functional capabilities of COPD patients is the role of comorbid disease [4,5]. There are several important steps in evaluating comorbid disease in COPD.…”

mentioning

confidence: 99%

Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD

Mannino

Thorn²,

Swensen³

et al. 2008

Eur Respir J

1,000

717

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Chronic obstructive pulmonary disease (COPD) is associated with important chronic comorbid diseases, including cardiovascular disease, diabetes and hypertension.The present study analysed data from 20,296 subjects aged o45 yrs at baseline in the Atherosclerosis Risk in Communities Study (ARIC) and the Cardiovascular Health Study (CHS). The sample was stratified based on baseline lung function data, according to modified Global Initiative for Obstructive Lung Disease (GOLD) criteria. Comorbid disease at baseline and death and hospitalisations over a 5-yr follow-up were then searched for.Lung function impairment was found to be associated with more comorbid disease. In logistic regression models adjusting for age, sex, race, smoking, body mass index and education, subjects with GOLD stage 3 or 4 COPD had a higher prevalence of diabetes (odds ratio (OR) 1.5, 95% confidence interval (CI) 1.1-1.9), hypertension (OR 1.6, 95% CI 1.3-1.9) and cardiovascular disease (OR 2.4, 95% CI 1.9-3.0). Comorbid disease was associated with a higher risk of hospitalisation and mortality that was worse in people with impaired lung function.Lung function impairment is associated with a higher risk of comorbid disease, which contributes to a higher risk of adverse outcomes of mortality and hospitalisations.

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Spectrum of heart failure in older patients: Results from the national heart failure project

Cited by 242 publications

References 10 publications

Change in Comorbidity Prevalence with Advancing Age Among Persons with Heart Failure

Change in Comorbidity Prevalence with Advancing Age Among Persons with Heart Failure

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

Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD

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