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Patients in primary health care diagnosed and treated as heart failure, with special reference to gender differences
1Health Care Centre of Atvidaberg, Linköping University Hospital, Sweden.
Insights
Heart failure (HF) diagnosis and treatment in primary care show room for improvement, particularly for women. Objective diagnostic methods and optimal angiotensin-converting enzyme (ACE) inhibitor use were less frequent in women compared to men.
Area of Science:
- Cardiology
- Primary Health Care Research
- Public Health
Background:
- Heart failure (HF) management in primary care settings requires ongoing evaluation.
- Understanding gender-based differences in HF diagnosis and treatment is crucial for equitable care.
Purpose of the Study:
- To describe the characteristics of patients with heart failure (HF) in a primary care setting.
- To analyze diagnostic procedures, etiological diseases, and management strategies for HF.
- To investigate gender-based differences in HF patient profiles and treatment.
Main Methods:
- A descriptive, retrospective investigation was conducted in the Atvidaberg community, Sweden.
- Data from 256 patients treated for symptomatic heart failure (HF) were analyzed.
- Key outcomes included HF prevalence, etiology, diagnostic methods, management, and gender comparisons.
Main Results:
- Objective cardiac function evaluation was used in only 31% of HF patients; Ischemic Heart Disease (IHD) and hypertension were common comorbidities.
- Diuretics, ACE inhibitors, and digoxin were common therapies, but only 52% received optimal ACE inhibitor doses.
- Women, who were older, had less frequent objective HF diagnosis (20%) and lower rates of ACE inhibitor prescription (43%) compared to men (64%).
Conclusions:
- Significant improvements are needed in primary care heart failure (HF) management.
- Women with HF face diagnostic and therapeutic disparities, with less frequent objective evaluation and suboptimal ACE inhibitor use.
- Addressing these gender-specific gaps is essential for enhancing HF care quality.
Objective:
The aim of the present study was to describe patients considered to have had heart failure (HF), or were being treated for HF, in a defined area in primary health care, e.g. diagnostic procedures, aetiologic diseases and management, and to evaluate whether there is a difference between the genders.
Design:
Descriptive retrospective investigation.
Setting:
Atvidaberg community situated in southeast Sweden, 12 400 inhabitants.
Patients:
256 patients treated for symptomatic HF.
Main Outcome Measures:
Prevalence, aetiology, diagnostic procedures and management of HF and differences between the genders.
Results:
The diagnosis of HF was based on an objective evaluation of cardiac function in only 31% of the patients. Ischaemic heart disease (IHD) was the predominant associated disease, followed by hypertension. Therapy included diuretics (84%), angiotensin converting enzyme (ACE) inhibitors (56%) and digoxin (40%). Only 52% had optimal doses of ACE inhibitors. Women had a significantly higher mean age and their diagnoses were based on an objective diagnostic test (echocardiography) in only 20%. Women were prescribed ACE inhibitors to a lesser extent (43%) than men (64%) and with a lower optimal dose (44% versus 56% in men).
Conclusion:
There is still room for improvement in the management of HF in primary health care, especially in women, where the diagnosis is not generally based on an objective evaluation of cardiac function and where the treatment to a lesser extent than in men includes ACE inhibitors.