Patients with cardiac disease: Changes observed through last decade in out-patient clinics

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide.
• Understanding the evolving profile of CVD patients is crucial for effective public health strategies and clinical practice.
• Longitudinal data allows for the assessment of trends in risk factors and disease prevalence over time.

Purpose of the Study:

• To delineate the current demographic and clinical profile of patients diagnosed with cardiovascular disease (CVD).
• To analyze and compare changes in CVD patient profiles and risk factors over a ten-year period.
• To identify shifts in the prevalence of specific CVD subtypes, including coronary heart disease (CHD), heart failure (HF), and atrial fibrillation (AF).

Main Methods:

• A comparative analysis of two cross-sectional registries of established CVD patients from 1999 (n=6194) and 2009 (n=4639).
• Data collection encompassed clinical antecedents, diagnoses (CHD, HF, AF), laboratory results (serum lipids, BP control), and medical treatments.
• Patients were recruited from outpatient clinics, with data gathered by cardiologists and primary care practitioners.

Main Results:

• An overall increase in cardiovascular risk factors was observed, with the exception of smoking. Blood pressure control showed a notable 54.4% relative increase.
• While coronary heart disease (CHD) remained the most prevalent CVD, heart failure (HF) and atrial fibrillation (AF) demonstrated significant increases of 41.5% and 33.7%, respectively.
• Serum lipid levels decreased significantly, coinciding with a 141.1% rise in statin use and increased utilization of other cardiovascular therapies, including ARBs in HF, beta-blockers in CHD, and oral anticoagulants in AF.

Conclusions:

• The decade studied witnessed an escalation in the prevalence of cardiovascular risk factors among patients with established CVD.
• Heart failure (HF) and atrial fibrillation (AF) emerged as the CVD subtypes with the most substantial increases in prevalence.
• Despite improvements in lipid profiles and increased use of guideline-directed medical therapies, the overall burden of cardiovascular risk factors has risen.