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Clinical and demographic profile and quality indicators for heart failure in a rural area
Henrique Miller Balieiro1, Raphael Kasuo Osugue, Samuel Pereira Rangel
1Faculdade de Medicina de Valença, Valença, RJ, Brasil.
Insights
Heart failure (HF) in Brazil
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Existing heart failure (HF) data in Brazil primarily originates from tertiary care centers.
- This data may not accurately represent the distinct social, economic, and cultural characteristics of rural populations.
- Understanding HF in rural settings is crucial for equitable healthcare provision.
Purpose of the Study:
- To determine the clinical and demographic profile of heart failure (HF) patients in rural Brazil.
- To assess quality indicators for HF management in rural areas.
- To identify specific characteristics of heart failure with reduced ejection fraction (HFREF) and heart failure with normal ejection fraction (HFNEF) in this population.
Main Methods:
- A transversal cohort study was conducted with 166 patients from a rural area in Valença, Rio de Janeiro, Brazil.
- Clinical, laboratorial, and echocardiographic data were collected and analyzed.
- Statistical tests including chi-square, Fisher's exact, and Student's t-test were employed to establish population characteristics.
Main Results:
- The study population had a mean age of 61 years, with 51% males and 53% Afro-Brazilian.
- Hypertension (91%) and metabolic syndrome (62%) were prevalent comorbidities.
- Common etiologies included hypertensive (46%) and ischemic (37%). Quality indicators showed 62% on beta-blockers and 88% on ACEI/ARB.
- HFNEF was more prevalent in females with metabolic syndrome and hypertensive etiology, while HFREF was associated with males and ischemic etiology.
Conclusions:
- Heart failure in rural Brazil shares similarities in sex, ethnicity, and classification with urban data.
- Hypertensive etiology is the most frequent cause of HF in this rural cohort.
- Distinct demographic and etiological profiles exist for HFNEF and HFREF in rural populations, highlighting the need for tailored management strategies.
Background:
data on heart failure (HF) in Brazil are ensued from tertiary centers. This information can not be extended to the rural population, for it reflects distinct social, economic and cultural characteristics.
Objective:
To establish the clinical and demographic profile and quality indicators for HF in rural areas.
Methods:
Transversal cohort study that included 166 patients from the rural area of Valença, Rio de Janeiro, Brazil. After the evaluation of clinical, laboratorial and echocardiograph data, chi-square and Fisher's exact tests were used for analysis of proportion, as well as the Student's t-test for numeric variables, in order to establish the population's characteristics.
Results:
Mean age was 61+/-14 years old, as 85 of them (51%) were men, 88 (53%) were afro-Brazilian and 85 (51%) had heart failure with reduced ejection fraction (HFREF). Systemic arterial hypertension (151 patients, 91%) and metabolic syndrome (103 patients, 62%) were prevalent comorbidities. The most common etiologies were: hypertensive (77 patients, 46%) and ischemic (62 patients, 37%). Quality indicators in HF were: 43 patients (26%) with previous echocardiogram, 102 patients (62%) were in use of beta-blockers, 147 patients (88%) received angiotensin converter enzyme inhibitor (ACEI) or angiotensin receptor blockers (ARB), and 22% of the patients with atrial fibrillation (AF) were under treatment with oral anticoagulation. For heart failure with normal ejection fraction (HFNEF), females (p=0.001; OD: 0.32; CI=0.17-0.60), metabolic syndrome (p=0.004; OD: 0.28; CI=1.31-4.78) and hypertensive etiology (p<0.0001; OD: 6.83; CI=3.45-13.5) were predominant. For CIREF, males (p=0.001; OD: 0.32; CI=0.170-0.605) and ischemic etiology (p<0.0001; OD: 0.16; CI=0.079-0.330) were predominant.
Conclusion:
In rural areas, HF shows similarity with regard to sex, ethnicity and classification. Hypertensive etiology was the most commonly present. HFNEF was prevalent among women and in the presence of metabolic syndrome, while HFREF was associated with males and ischemic etiology.
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