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[Galician study of heart failure in primary care (GALICAP Study)]
Fernando Otero-Raviña1, Lilian Grigorian-Shamagian, Luis Fransi-Galiana
1Sección de Coordinación Asistencial, SERGAS, Santiago de Compostela, A Coruña, Spain.
Insights
Heart failure with preserved systolic function is common in Galicia, often linked to uncontrolled high blood pressure. Treatment requires improvement, with intervention programs needed for better heart failure patient care.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Context:
- Heart failure (HF) presents a significant public health challenge.
- Understanding the specific characteristics of HF patients in regional populations is crucial for targeted interventions.
- This study focuses on the HF patient cohort in Galicia, Spain.
Purpose:
- To characterize the demographic, clinical, and therapeutic profiles of heart failure patients in Galicia.
- To identify prevalent HF types and associated risk factors within this population.
- To assess current management practices and treatment outcomes.
Summary:
- The study analyzed 1195 heart failure patients in Galicia, Spain.
- Heart failure with preserved systolic function was most prevalent, frequently associated with hypertension.
- Key comorbidities included hypertension (82%), atrial fibrillation (49%), and hyperlipidemia (47%).
- Blood pressure control was suboptimal in 57% of patients.
- Coronary angiography use in ischemic heart disease varied by sex.
- Prescribed medications, including diuretics and ACE inhibitors, indicated suboptimal treatment in many cases.
- Hospitalization rates were high, with 45% of admissions for cardiovascular reasons.
Impact:
- Findings highlight the need for improved hypertension management in heart failure patients.
- The study underscores sex-based disparities in diagnostic procedures for ischemic heart disease.
- Results indicate a need for enhanced therapeutic strategies and intervention programs to optimize heart failure care in Galicia.
Introduction And Objectives:
Heart failure (HF) is an important public health concern. Our aim was to evaluate the characteristics of HF patients in Galicia, Spain.
Methods:
This descriptive, cross-sectional, multicenter study involved 149 primary care physicians and recorded the characteristics of 1195 patients diagnosed with HF.
Results:
Some 48% of patients were male, and their mean age was 76 years, though women were older (P<.001). Disease history included hypertension in 82%, hyperlipidemia in 47%, diabetes in 31%, atrial fibrillation in 49%, valvular disease in 35%, and ischemic heart disease in 32%. Mean systolic and diastolic blood pressures were 131 mm Hg and 76 mm Hg, respectively. Pressure was controlled (= 130/80 mm Hg) in 43% of patients. Overall, 67% underwent echocardiography, of whom 61% had preserved systolic function. Coronary angiography was performed in 47% of patients with ischemic heart disease, more frequently in males than females (P<.001). The most commonly prescribed drugs were diuretics (82%), angiotensin-converting enzyme (ACE) inhibitors (48%), angiotensin II receptor antagonists (29%), and beta-blockers (27%). Patients with depressed systolic function were more frequently prescribed beta-blockers (P<.001), ACE inhibitors (P<.01), and antialdosterones (P<.05). During the last year, 57% of patients had been admitted to hospital, of whom 45% were admitted for cardiovascular reasons.
Conclusions:
The most prevalent form of HF in Galicia was HF with preserved systolic function, which was mostly associated with high blood pressure due to poor control. In patients with ischemic heart disease, the use of coronary angiography was influenced by sex. Drug treatment was suboptimal. Intervention programs are required to improve care in these patients.
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