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[Heart failure patients in Primary Care: aging, comorbidities and polypharmacy]
Gisela Galindo Ortego1, Inés Cruz Esteve, Jordi Real Gatius
1CAP Primer de Maig, Lleida, España. ggalindo.lleida.ics@gencat.cat
Objective:
To assess heart failure prevalence, epidemiology, co-morbidities and polypharmacy in our region from electronic patient records. To evaluate gender differences in heart failure patients.
Design:
Descriptive, cross-sectional study.
Setting:
Primary care Lleida (Spain).
Participants:
All patients from 21 primary care centers with the diagnosis of heart failure in medical records were included.
Main Outcome Measurements:
Demographic data, comorbidities and therapeutical subgroups in patients with a diagnosis of heart failure in their clinical record.
Results:
Heart failure was found in 0.99% (3017 from 306229 patients), of whom 59% were women, and a mean age of 80 years. Comorbidities: hypertension 67%, diabetes 30%, hyperlipidemia 26.5%, obesity 27%, ischemic heart disease 19%, stroke 11%, atrial fibrillation 31%, COPD 26%, renal failure 12%. Hypertension, hyperlipidemia and obesity were more frequent in women, COPD, ischemic heart disease and renal failure in men. There were no differences in diabetes, stroke and atrial fibrillation. Patients were prescribed a median of 8 different therapeutic subgroups (P25=6 and P75=11). Women were more frequently prescribed diuretics (76%), cardiac glycosides (22%) and ACE inhibitors/angiotensin II receptor antagonists, and men ACE inhibitors/angiotensin II receptor antagonists in combination with beta-blockers.
Conclusions:
Heart failure patients in primary care are elderly, with significant co-morbidities and treated with a high number of drugs. Gender differences exist in cardiovascular risk factors, co-morbidities, and also in therapy.
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