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Burden of heart failure in Flemish general practices: a registry-based study in the Intego database
OBJECTIVES: To assess the prevalence and incidence of heart failure (HF) stages A to C/D and their evolution over a 16-year period. Additionally, trends in comorbidities and cardiovascular (CV) treatment in patients with HF were studied in the same period. DESIGN: Registry-based study. SETTING: Prim...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326340/ https://www.ncbi.nlm.nih.gov/pubmed/30617099 http://dx.doi.org/10.1136/bmjopen-2018-022972 |
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author | Smeets, Miek Vaes, Bert Mamouris, Pavlos Van Den Akker, Marjan Van Pottelbergh, Gijs Goderis, Geert Janssens, Stefan Aertgeerts, Bert Henrard, Séverine |
author_facet | Smeets, Miek Vaes, Bert Mamouris, Pavlos Van Den Akker, Marjan Van Pottelbergh, Gijs Goderis, Geert Janssens, Stefan Aertgeerts, Bert Henrard, Séverine |
author_sort | Smeets, Miek |
collection | PubMed |
description | OBJECTIVES: To assess the prevalence and incidence of heart failure (HF) stages A to C/D and their evolution over a 16-year period. Additionally, trends in comorbidities and cardiovascular (CV) treatment in patients with HF were studied in the same period. DESIGN: Registry-based study. SETTING: Primary care, Flanders, Belgium. PARTICIPANTS: Data were obtained from Intego, a morbidity registration network in which 111 general practitioners of 48 practices collaborate. In the study period between 2000 and 2015, data from 165 796 unique patients aged 45 years and older were available. OUTCOME MEASURES: Prevalence and incidence were calculated for HF stage A, B and C/D by gender. Additionally, the trend in age-standardised prevalence and incidence rates between 2000 and 2015 was analysed with joint-point regression. The same model was used to study trends in comorbidity profiles in incident HF cases and trends in cardiovascular medication in prevalent HF cases. RESULTS: We found a downward trend in the incidence and prevalence of HF stage C/D in Flemish general practice between 2000 and 2015, whereas the prevalence and incidence of stage A and B increased. The burden of comorbidities in incident HF cases increased during the study period, as shown by an increasing disease count (p<0.001). The prescription of cardiovascular medication such as renin-angiotensin-aldosterone system blockade, β-blockers and statins showed a sharp increase in the first part of the study period (2000–2008). CONCLUSION: Age-standardised incidence and prevalence of HF stage C/D showed a slightly downward trend over the past 16 years, probably due to the sharp increase in cardiovascular treatment. However, the increasing age-standardised incidence and prevalence of stage A and B, as precursors of symptomatic HF, together with a rising comorbid burden, highlights the challenges we are still facing. |
format | Online Article Text |
id | pubmed-6326340 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-63263402019-01-25 Burden of heart failure in Flemish general practices: a registry-based study in the Intego database Smeets, Miek Vaes, Bert Mamouris, Pavlos Van Den Akker, Marjan Van Pottelbergh, Gijs Goderis, Geert Janssens, Stefan Aertgeerts, Bert Henrard, Séverine BMJ Open Cardiovascular Medicine OBJECTIVES: To assess the prevalence and incidence of heart failure (HF) stages A to C/D and their evolution over a 16-year period. Additionally, trends in comorbidities and cardiovascular (CV) treatment in patients with HF were studied in the same period. DESIGN: Registry-based study. SETTING: Primary care, Flanders, Belgium. PARTICIPANTS: Data were obtained from Intego, a morbidity registration network in which 111 general practitioners of 48 practices collaborate. In the study period between 2000 and 2015, data from 165 796 unique patients aged 45 years and older were available. OUTCOME MEASURES: Prevalence and incidence were calculated for HF stage A, B and C/D by gender. Additionally, the trend in age-standardised prevalence and incidence rates between 2000 and 2015 was analysed with joint-point regression. The same model was used to study trends in comorbidity profiles in incident HF cases and trends in cardiovascular medication in prevalent HF cases. RESULTS: We found a downward trend in the incidence and prevalence of HF stage C/D in Flemish general practice between 2000 and 2015, whereas the prevalence and incidence of stage A and B increased. The burden of comorbidities in incident HF cases increased during the study period, as shown by an increasing disease count (p<0.001). The prescription of cardiovascular medication such as renin-angiotensin-aldosterone system blockade, β-blockers and statins showed a sharp increase in the first part of the study period (2000–2008). CONCLUSION: Age-standardised incidence and prevalence of HF stage C/D showed a slightly downward trend over the past 16 years, probably due to the sharp increase in cardiovascular treatment. However, the increasing age-standardised incidence and prevalence of stage A and B, as precursors of symptomatic HF, together with a rising comorbid burden, highlights the challenges we are still facing. BMJ Publishing Group 2019-01-07 /pmc/articles/PMC6326340/ /pubmed/30617099 http://dx.doi.org/10.1136/bmjopen-2018-022972 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Cardiovascular Medicine Smeets, Miek Vaes, Bert Mamouris, Pavlos Van Den Akker, Marjan Van Pottelbergh, Gijs Goderis, Geert Janssens, Stefan Aertgeerts, Bert Henrard, Séverine Burden of heart failure in Flemish general practices: a registry-based study in the Intego database |
title | Burden of heart failure in Flemish general practices: a registry-based study in the Intego database |
title_full | Burden of heart failure in Flemish general practices: a registry-based study in the Intego database |
title_fullStr | Burden of heart failure in Flemish general practices: a registry-based study in the Intego database |
title_full_unstemmed | Burden of heart failure in Flemish general practices: a registry-based study in the Intego database |
title_short | Burden of heart failure in Flemish general practices: a registry-based study in the Intego database |
title_sort | burden of heart failure in flemish general practices: a registry-based study in the intego database |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326340/ https://www.ncbi.nlm.nih.gov/pubmed/30617099 http://dx.doi.org/10.1136/bmjopen-2018-022972 |
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