Prevalence Of Diastolic Heart Failure Research Articles

Diastolic heart failure in older people.

To determine the prevalence of diastolic heart failure in older people in the community, identify associated risk factors and measure its impact on function and quality of life. Cross-sectional population-based study. A two-stage random sample of 500 subjects was drawn from 5,002 subjects aged 70 years and over living at home. Diastolic heart failure was diagnosed by a panel of three physicians, based on clinical assessment and echocardiographic indicators of diastolic dysfunction. Prevalence of diastolic heart failure and its effect on function and quality of life as measured by Nottingham Extended Activities of Daily Living, Hospital Anxiety and Depression and SF-36 questionnaires. The prevalence of diastolic heart failure was 5.54% (95% CI = 3.71, 7.87) and was higher in women (8.32%) than in men (1.25%), P = 0.008. On multivariate analysis of variance, diastolic heart failure was associated with female gender and history of ischaemic heart disease. Subjects with diastolic heart failure had significantly poorer functional status and physical health than those without heart failure. Diastolic heart failure is relatively common in older people and is associated with adverse affects in older people's lives.

Treatment of hypertension for patients with diastolic dysfunction.

Diastolic dysfunction is a poorly understood pathophysiological entity; its importance is magnified by the increasing prevalence of diastolic heart failure. Forty-six million people in the US are experiencing heart failure and 550000 new cases are diagnosed annually. A large percentage of these patients with heart failure have a normal or nearly normal left-ventricular ejection fraction. Isolated diastolic dysfunction may be associated with an increased mortality. One of the major causes of diastolic dysfunction is hypertension. Advances in diagnosis and treatment strategies may improve the clinical outcome for patients with diastolic dysfunction.

Heart failure in octogenarians: etiology and type of dysfunction

The aim of this study was to analyze the etiology and type of dysfunction in octogenarians with heart failure and at the same time establish if there are differences with a geriatric but younger population. A total of 180 consecutive inpatients with heart failure were studied between April 2001 and September 2002, 115 older than 80 years, and 65 between 65 and 80 years. We analyzed the following etiologies: 1) ischemic heart disease, 2) hypertension, 3) valvular heart disease, 4) chagasic cardiomyopathy, 5) idiopathic, 6) others. We compared the presence of systolic and diastolic heart failure between both groups. An uni. and multivariate analysis was carried out using the Epidat and Statistix. The etiologic factors were: 1) ischemic heart disease: 37.3 % vs 53.4 % (OR, 4.47; 95 % CI, 0.27-0.99; p < 0.03) by univariate analysis; 2) hypertension: 58.2 % vs 43.8 % (p=ns); 3) valvular heart disease: 26.9 % vs 23.2 % (p=ns); 4) chagasic cardiomyopathy: 0% vs 2.7% (p=ns); 5) idiopathic: 11.3 % vs 6.8 % (p=ns); others: 3.4 % vs 5.4 % (p=ns), 6) systolic heart failure: 35.6 % vs 47.9 % (p=ns), 7) diastolic heart failure: 40.8 % vs 21.9 % (OR, 6.28; 95 % CI, 0.01-0.87; p < 0.01) by univariate analysis, and (OR, 0.35; 95 % CI, 0.14-0.845; p < 0.02) by multivariate analysis, in patients older than 80 years vs patients between 65 and 80 years. In conclusion, in this group of patients with heart failure there were no differences in the etiology between patients who were older or younger than 80 years old. In spite of this, octogenarians had a higher prevalence of diastolic heart failure.

The prevalence of diastolic heart failure in the community

The prevalence of diastolic heart failure in the community

Is hypertension a leading cause of heart failure in Chinese?

1. There is considerable uncertainty regarding the importance of various risk factors in the development of heart failure. Most data are from Caucasian populations, where hypertension and coronary artery disease appear dominant. 2. Because it cannot be presumed that risk factor profiles will be identical for all races, we reviewed the literature on the aetiology of heart failure in Chinese. 3. There are, apparently, no long-term prospective studies defining the risk factors for heart failure in Chinese. Studies from Hong Kong in the 1990s point to an overlap of risk factors (especially hypertension, ischaemic heart disease and diabetes) and a high prevalence of diastolic heart failure (66%). Antihypertensive drug treatment appears likely to protect against the development of heart failure but end-points from formal trials are too small to be certain. 4. Available data, short of being definitive, point to hypertension being the most important identifiable risk factor in Chinese with heart failure. This may change with diabetes mellitus becoming more prevalent in the Chinese population.

Prevalence of diastolic heart failure among patients admitted to hospital with congestive heart failure

Prevalence of diastolic heart failure among patients admitted to hospital with congestive heart failure

Comparison of frequencies of left ventricular systolic and diastolic heart failure in chinese living in Hong Kong

There is a wide variation (13% to 74%) in the reported prevalence of heart failure associated with normal left ventricular (LV) systolic function (diastolic heart failure). There is no published information on this condition in China. To ascertain the prevalence of diastolic heart failure in this community, 200 consecutive patients with the typical features of congestive heart failure were studied with standard 2-dimensional Doppler echocardiography. A LV ejection fraction (LVEF) >45% was considered normal. The results showed that 12.5% had significant valvular heart disease. Of the remaining 175 patients, 132 had a LVEF >45% (75%). Therefore, 66% of patients with a clinical diagnosis of heart failure had a normal LVEF. Heart failure with normal LV systolic function was more common than systolic heart failure in those >70 years old (65% vs 47%; p = 0.015). Most (57%) had an abnormal relaxation pattern in diastole and 14% had a restrictive filling pattern. In the systolic heart failure group, a restrictive filling pattern was more common (46%). There were no significant differences in the sex distribution, etiology, or prevalence of LV hypertrophy between these 2 heart failure groups. In conclusion, heart failure with a normal LVEF or diastolic heart failure is more common than systolic heart failure in Chinese patients with the symptoms of heart failure. This may be related to older age at presentation and the high prevalence of hypertension in this community.

Inappropriate use of digoxin in the elderly: how widespread is the problem and how can it be solved?

Cardiovascular disease is ubiquitous within the elderly population and requires treatment with multiple types of medications. As with any cardiovascular pharmaceutical regimen, the risk versus the benefit of each medication must be strongly considered. This is particularly true where, for various reasons, adverse effects are more often prevalent and pronounced. Over the years, it has been documented that digoxin is a frequently prescribed medication in elderly populations. Although this drug can be beneficial when used in the appropriate setting, recent data would suggest that inappropriate administration of digoxin is common and not without potentially serious consequences. Currently, the use of digoxin can be advocated to control heart failure in atrial fibrillation and when added to ACE inhibitors and diuretics in those patients with symptomatic heart failure related to systolic left ventricular dysfunction. It is likely that the excessive use of digoxin in elderly populations as discussed in this review is perhaps based on the prevalence of diastolic heart failure in the elderly as well as other co-morbid conditions that may mimic heart failure signs and symptoms. Since the elderly appear to be at high risk for digoxin toxicity, the inappropriate use of this medication to treat these conditions could result in significant and unnecessary morbidity. It is proposed that echocardiography should be performed in most elderly patients when congestive heart failure is suspected. This simple diagnostic tool, along with a careful history and medical examination, would hopefully prevent the misinterpretation of confusing clinical findings and would help to identify the patients with normal systolic function or valvular disease such as critical aortic stenosis, where digoxin treatment would not be warranted. If it is necessary to administer digoxin, then the likelihood of significant toxicity can be greatly reduced by using an algorithm to calculate the appropriate dosage, which takes into consideration the patient's gender, bodyweight and creatinine clearance. Although it is probable that the indications for digoxin use to treat congestive heart failure will continue to evolve, at the present time most would recommend using this agent in symptomatic heart failure related to a reduction in left ventricular systolic function or when associated with atrial fibrillation.