Abstract
Background
Diagnosing heart failure (HF) in primary care can be challenging, especially
in elderly patients with comorbidities. Insight in the prevalence, age,
comorbidity and routine practice of diagnosing HF in general practice may
improve the process of diagnosing HF.
Aim
To examine the prevalence of HF in relation to ageing and comorbidities, and
routine practice of diagnosing HF in general practice.
Methods
A retrospective cohort study was performed using data from electronic health
records of 56 320 adult patients of 11 general practices. HF patients were
compared with patients without HF using descriptive analyses and
χ2 tests. The following comorbidities were considered: chronic
obstructive pulmonary disorder (COPD), diabetes mellitus (DM), hypertension,
anaemia and renal function disorder (RFD). Separate analyses were performed
for men and women.
Findings
The point prevalence of HF was 1.2% (95% confidence interval
1.13–1.33) and increased with each age category from 0.04%
(18–44 years) to 20.9% (⩾85 years). All studied
comorbidities were significantly (P<0.001) more
common in HF patients than in patients without HF: COPD (24.1% versus
3.1%), DM (34.7% versus 6.5%), hypertension
(52.7% versus 16.0%), anaemia (10.9% versus
2.3%) and RFD (61.8% versus 7.5%). N-terminal pro-BNP
(NT-proBNP) was recorded in 38.1% of HF patients.
Conclusions
HF is highly associated with ageing and comorbidities. Diagnostic use of
NT-proBNP in routine primary care seems underutilized. Instruction of GPs to
determine NT-proBNP in patients suspected of HF is recommended, especially
In elderly patients with comorbidities.
Heart failure in primary care: prevalence related to age and
comorbidity
