The prevalence and characteristics of pruritus in patients with heart failure

Pruritus (itching) can be a distressing symptom, and previous research suggests that it is common in patients with chronic heart failure (CHF).

The primary aim was to examine the prevalence of itching in patients with CHF and to compare this first to that among patients with coronary artery disease (CAD) and second to that of a normal Swedish population. The study also explored characteristics and possible causes of pruritus in patients with CHF.

In this cross-sectional prevalence study, a questionnaire was sent to 130 patients with CHF and to 130 with CAD. A total of 85 patients with CHF (65·4%) and 82 with CAD (63·1%) participated. Data were also compared with those of a previous study examining symptoms in a normal Swedish population.

The prevalence of itching at some point during the last 3 months was 40·0% in patients with CHF and 23·2% in patients with CAD (P = 0·019). This difference was not significant after adjusting for sex, age and medication. Patients with CHF described their pruritus as more disturbing than patients with CAD. In addition, 13·6% of patients with CHF and 3·8% of persons in the normal population experienced itching every week without any rash (P = 0·001).

Pruritus is common and sometimes disturbing in patients with CHF and warrants clinical attention. Medication should be considered as a cause of itching and may explain differences in the prevalence between patients with CHF and those with CAD. However, other causes of itching in patients with CHF should be explored in prospective studies.