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Diastolic heart failure in older people
M Sinead O'Mahony1, M F Victor Sim, Shu F Ho
1University of Wales College of Medicine,University Department of Geriatric Medicine, Llandough Hospital, Penarth, UK. omahonyms@cf.ac.uk
Objectives:
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.
Design:
Cross-sectional population-based study.
Methods:
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.
Main Outcome Measures:
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.
Results:
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.
Conclusions:
Diastolic heart failure is relatively common in older people and is associated with adverse affects in older people's lives.