Abstract
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. To examine the prevalence of HF in relation to ageing and comorbidities, and routine practice of diagnosing HF in general practice. 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. 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. 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.
Highlights
Heart failure (HF) affects an estimated 26 million people worldwide (Ambrosy et al, 2014) and this number is expected to be increasing due to the ageing population and improved survival following acute cardiac events (Hobbs et al, 2002; Bleumink et al, 2004)
The overall point prevalence of heart failure (HF) in the adult population was 1.3% in men and 1.2% in women (Table 2)
The point prevalence in men and women increased with each age category, starting with 0.04% in patients younger than 44 years and increasing to 20.9% in patients aged 85 years or older
Summary
Heart failure (HF) affects an estimated 26 million people worldwide (Ambrosy et al, 2014) and this number is expected to be increasing due to the ageing population and improved survival following acute cardiac events (Hobbs et al, 2002; Bleumink et al, 2004). Diagnosing heart failure (HF) in primary care can be challenging, especially in elderly patients with comorbidities. 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. 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%). Instruction of GPs to determine NT-proBNP in patients suspected of HF is recommended, especially In elderly patients with comorbidities
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