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Heart failure in a multiethnic population in Kuala Lumpur, Malaysia
Aun-Yeong Chong1, Ratna Rajaratnam, Nur Run Hussein
1University Department of Medicine, City Hospital, B18 7QH, Birmingham, UK.
Insights
Congestive heart failure (CHF) affects 6.7% of acute medical admissions in Malaysia, primarily due to coronary artery disease. Standard treatments like ACE inhibitors are underutilized, mirroring Western trends.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Cardiovascular disease exhibits racial disparities globally.
- Limited data exists on congestive heart failure (CHF) epidemiology in non-white populations.
- Understanding CHF in diverse populations is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence of CHF in Malaysia's multiracial population.
- To characterize the clinical presentation of CHF patients.
- To assess the management strategies employed for CHF in Malaysia.
Main Methods:
- A prospective study conducted at a general hospital in Kuala Lumpur, Malaysia.
- Inclusion criteria: acute medical admissions over a 4-week period.
- Data collection focused on primary diagnosis, etiology, and medication use.
Main Results:
- Congestive heart failure (CHF) accounted for 6.7% of 1435 acute medical admissions.
- Coronary artery disease was the leading cause (49.5%), followed by hypertension (18.6%).
- Diabetes mellitus was prevalent in Indian patients; angiotensin-converting enzyme (ACE) inhibitor use was low (43.3%).
Conclusions:
- CHF prevalence was 6.7% among acute medical admissions in this Malaysian center.
- Coronary artery disease is the primary driver of heart failure in this population.
- Underutilization of ACE inhibitors in CHF management was observed, similar to Caucasian populations.
Background:
There are established differences in cardiovascular disease in different racial groups. Worldwide, the literature regarding the clinical epidemiology of congestive heart failure (CHF) in non-white populations is scarce.
Objectives:
To document the prevalence of CHF in the multiracial population of Malaysia, and to describe the clinical features and management of these patients.
Setting:
Busy city centre general hospital in Kuala Lumpur, Malaysia.
Results:
Of 1435 acute medical admissions to Kuala Lumpur General Hospital over the 4-week study period, 97 patients (6.7%) were admitted with the primary diagnosis of CHF. Coronary artery disease was the main aetiology of CHF, accounting for almost half (49.5%) the patients, followed by hypertension (18.6%). However, there were variations in associated aetiological factors between ethnic groups, with diabetes mellitus affecting the majority of Indians-as well as underutilisation of standard drugs for CHF, such as the angiotensin converting enzyme (ACE) inhibitors, which were only used in 43.3%.
Conclusion:
Amongst acute medical admissions to a single centre in Malaysia the prevalence of CHF was 6.7%. Coronary artery disease was the major aetiological factor in heart failure accounting for almost half the admissions. The under-prescription of ACE inhibitors was similar to other clinical surveys carried out amongst Caucasian populations in the West.