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Prevalence of heart failure in three general practices in north west London
J Parameshwar1, M M Shackell, A Richardson
1National Heart and Lung Institute, London.
Insights
Heart failure prevalence in the UK is 3.9 per 1000 patients, primarily affecting those over 65. Coronary heart disease is the leading cause, with most patients requiring hospital care.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Limited recent data exists on heart failure prevalence in the United Kingdom.
- Heart failure significantly impacts public health, particularly in aging populations.
Purpose of the Study:
- To determine the current prevalence of heart failure in the UK.
- To identify the primary etiological factors and patient demographics associated with heart failure.
Main Methods:
- Utilized data from three general practices in North West London, identifying patients on diuretic drugs.
- Analyzed practice records for 30,204 patients to confirm heart failure diagnoses.
- Examined patient demographics, etiological factors, and treatment pathways.
Main Results:
- Identified 117 heart failure cases, yielding a prevalence of 3.9 per 1000 patients.
- Prevalence was significantly higher in individuals aged 65 and over (27.7 per 1000) compared to younger groups (0.6 per 1000).
- Coronary heart disease (32%) was the most common cause, followed by valve disease (19%); etiology remained unknown for 37%.
Conclusions:
- Heart failure predominantly affects elderly patients in the UK.
- Coronary heart disease is the leading etiological factor for heart failure.
- Most heart failure patients require hospital referral, with diagnostic echocardiograms underutilized.
Abstract:
There is little recent information on the prevalence of heart failure in the United Kingdom. Assuming that patients with heart failure would be taking diuretic drugs all such patients were identified in three general practices in north west London. The practice records of these patients were examined to determine which patients had heart failure. Of the 30,204 patients served by the practices, 117 had heart failure, a prevalence of 3.9 per 1000 patients. The mean age of these patients was 74 years. The prevalence of heart failure among patients under 65 years of age was 0.6 per 1000 patients rising to 27.7 per 1000 among those aged 65 years and over. The aetiology of heart failure was considered to be coronary heart disease for 32% of patients, valve disease for 19%, hypertension for 6%, cor pulmonale for 4% and congenital heart disease for 2%. The aetiology for the remaining 37% of patients was unknown. Most patients were referred to hospital and only 20% had been treated solely by the general practitioner. An electrocardiogram and chest radiograph had been obtained for over 80% of patients but only 28% had an echocardiogram. Heart failure occurs primarily in elderly patients, and coronary heart disease is the dominant aetiological factor.