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Prevalence of Chronic Heart Failure, Associated Factors, and Therapeutic Management in Primary Care Patients in Spain, IBERICAN Study

Background: The prevalence of chronic heart failure (CHF) in patients assisted in primary care is not well known. We investigated the prevalence of CHF, its associated factors, and its therapeutic management. Methods and findings: This was a cross-sectional, multicenter study conducted in primary ca...

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Autores principales: Llisterri-Caro, Jose L., Cinza-Sanjurjo, Sergio, Martín-Sánchez, Vicente, Rodríguez-Roca, Gustavo C., Micó-Pérez, Rafael M., Segura-Fragoso, Antonio, Velilla-Zancada, Sonsoles, Polo-García, Jose, Barquilla-García, Alfonso, Rodríguez Padial, Luis, Prieto-Díaz, Miguel A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8471153/
https://www.ncbi.nlm.nih.gov/pubmed/34575146
http://dx.doi.org/10.3390/jcm10184036
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author Llisterri-Caro, Jose L.
Cinza-Sanjurjo, Sergio
Martín-Sánchez, Vicente
Rodríguez-Roca, Gustavo C.
Micó-Pérez, Rafael M.
Segura-Fragoso, Antonio
Velilla-Zancada, Sonsoles
Polo-García, Jose
Barquilla-García, Alfonso
Rodríguez Padial, Luis
Prieto-Díaz, Miguel A.
author_facet Llisterri-Caro, Jose L.
Cinza-Sanjurjo, Sergio
Martín-Sánchez, Vicente
Rodríguez-Roca, Gustavo C.
Micó-Pérez, Rafael M.
Segura-Fragoso, Antonio
Velilla-Zancada, Sonsoles
Polo-García, Jose
Barquilla-García, Alfonso
Rodríguez Padial, Luis
Prieto-Díaz, Miguel A.
author_sort Llisterri-Caro, Jose L.
collection PubMed
description Background: The prevalence of chronic heart failure (CHF) in patients assisted in primary care is not well known. We investigated the prevalence of CHF, its associated factors, and its therapeutic management. Methods and findings: This was a cross-sectional, multicenter study conducted in primary care (PC) in baseline patients of the IBERICAN study (Identification of the Spanish Population at Cardiovascular and Renal Risk). CHF was defined as the presence of this condition in the medical history, classifying patients according to the type of ventricular dysfunction in CHF with preserved ejection fraction (pEF), or CHF with reduced ejection fraction (rEF). Clinical characteristics, relationship between CHF and main cardiovascular risk factors (CVRF), and drug treatments used according to ejection fraction (EF) were analyzed. Results: A total of 8066 patients were included (54.5% women), average age (SD) was 57.9 (14.8) years, of which 3.1% (95% CI: 2.3–3.7) presented CHF, without differences between men and women. CHF with pEF (61.8%; 95% CI: 55.5–67.6) was more frequent in women, and CHF with rEF (38.1%; 95% CI: 33.2–45.5) (p = 0.028) was similar in both genders (65.9%; 95% CI: 57.1–73.4 vs. 57.3%; 95% CI: 47.7–65.8) (p = 0.188). A progressive increase of the prevalence with age (15.2% in ≥80 years) and with the aggregation of CVRF was observed. The most prescribed treatments were beta-blockers (54.7%) followed by angiotensin converting enzyme inhibitors (42.8%) and angiotensin II receptor antagonists (41.3%), without differences between pEF and rEF. The variables that are most associated with the probability of suffering CHF were a personal history of left ventricular hypertrophy (OR: 5.968; p < 0.001), of atrial fibrillation (OR: 3.494; p < 0.001), and of peripheral vascular disease (OR: 2.029; p < 0.001). Conclusions: Three in every 100 patients included in the IBERICAN study presented CHF, of which two thirds had pEF. The condition increased exponentially with age and aggregation of CVRF. We did not find any differences in drug treatment according to the type of ventricular dysfunction. The treatment of HF with rEF has much room for improvement.
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spelling pubmed-84711532021-09-27 Prevalence of Chronic Heart Failure, Associated Factors, and Therapeutic Management in Primary Care Patients in Spain, IBERICAN Study Llisterri-Caro, Jose L. Cinza-Sanjurjo, Sergio Martín-Sánchez, Vicente Rodríguez-Roca, Gustavo C. Micó-Pérez, Rafael M. Segura-Fragoso, Antonio Velilla-Zancada, Sonsoles Polo-García, Jose Barquilla-García, Alfonso Rodríguez Padial, Luis Prieto-Díaz, Miguel A. J Clin Med Article Background: The prevalence of chronic heart failure (CHF) in patients assisted in primary care is not well known. We investigated the prevalence of CHF, its associated factors, and its therapeutic management. Methods and findings: This was a cross-sectional, multicenter study conducted in primary care (PC) in baseline patients of the IBERICAN study (Identification of the Spanish Population at Cardiovascular and Renal Risk). CHF was defined as the presence of this condition in the medical history, classifying patients according to the type of ventricular dysfunction in CHF with preserved ejection fraction (pEF), or CHF with reduced ejection fraction (rEF). Clinical characteristics, relationship between CHF and main cardiovascular risk factors (CVRF), and drug treatments used according to ejection fraction (EF) were analyzed. Results: A total of 8066 patients were included (54.5% women), average age (SD) was 57.9 (14.8) years, of which 3.1% (95% CI: 2.3–3.7) presented CHF, without differences between men and women. CHF with pEF (61.8%; 95% CI: 55.5–67.6) was more frequent in women, and CHF with rEF (38.1%; 95% CI: 33.2–45.5) (p = 0.028) was similar in both genders (65.9%; 95% CI: 57.1–73.4 vs. 57.3%; 95% CI: 47.7–65.8) (p = 0.188). A progressive increase of the prevalence with age (15.2% in ≥80 years) and with the aggregation of CVRF was observed. The most prescribed treatments were beta-blockers (54.7%) followed by angiotensin converting enzyme inhibitors (42.8%) and angiotensin II receptor antagonists (41.3%), without differences between pEF and rEF. The variables that are most associated with the probability of suffering CHF were a personal history of left ventricular hypertrophy (OR: 5.968; p < 0.001), of atrial fibrillation (OR: 3.494; p < 0.001), and of peripheral vascular disease (OR: 2.029; p < 0.001). Conclusions: Three in every 100 patients included in the IBERICAN study presented CHF, of which two thirds had pEF. The condition increased exponentially with age and aggregation of CVRF. We did not find any differences in drug treatment according to the type of ventricular dysfunction. The treatment of HF with rEF has much room for improvement. MDPI 2021-09-07 /pmc/articles/PMC8471153/ /pubmed/34575146 http://dx.doi.org/10.3390/jcm10184036 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Llisterri-Caro, Jose L.
Cinza-Sanjurjo, Sergio
Martín-Sánchez, Vicente
Rodríguez-Roca, Gustavo C.
Micó-Pérez, Rafael M.
Segura-Fragoso, Antonio
Velilla-Zancada, Sonsoles
Polo-García, Jose
Barquilla-García, Alfonso
Rodríguez Padial, Luis
Prieto-Díaz, Miguel A.
Prevalence of Chronic Heart Failure, Associated Factors, and Therapeutic Management in Primary Care Patients in Spain, IBERICAN Study
title Prevalence of Chronic Heart Failure, Associated Factors, and Therapeutic Management in Primary Care Patients in Spain, IBERICAN Study
title_full Prevalence of Chronic Heart Failure, Associated Factors, and Therapeutic Management in Primary Care Patients in Spain, IBERICAN Study
title_fullStr Prevalence of Chronic Heart Failure, Associated Factors, and Therapeutic Management in Primary Care Patients in Spain, IBERICAN Study
title_full_unstemmed Prevalence of Chronic Heart Failure, Associated Factors, and Therapeutic Management in Primary Care Patients in Spain, IBERICAN Study
title_short Prevalence of Chronic Heart Failure, Associated Factors, and Therapeutic Management in Primary Care Patients in Spain, IBERICAN Study
title_sort prevalence of chronic heart failure, associated factors, and therapeutic management in primary care patients in spain, iberican study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8471153/
https://www.ncbi.nlm.nih.gov/pubmed/34575146
http://dx.doi.org/10.3390/jcm10184036
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