Article Text

Download PDFPDF

National survey of the prevalence, incidence, primary care burden, and treatment of heart failure in Scotland
Free
  1. N F Murphy1,
  2. C R Simpson2,
  3. F A McAlister3,
  4. S Stewart4,
  5. K MacIntyre5,
  6. M Kirkpatrick6,
  7. J Chalmers6,
  8. A Redpath6,
  9. S Capewell7,
  10. J J V McMurray1
  1. 1Department of Cardiology, Western Infirmary, Glasgow, UK
  2. 2Department of General Practice and Primary Care, University of Aberdeen, Aberdeen, UK
  3. 3Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
  4. 4Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
  5. 5Department of Public Health, University of Glasgow, Glasgow, UK
  6. 6Information and Statistics Division, Trinity Park House, Edinburgh, UK
  7. 7Department of Public Health, University of Liverpool, Liverpool, UK
  1. Correspondence to:
    Professor John J V McMurray
    Department of Cardiology, Western Infirmary, Glasgow, G11 6NT, UK; j.mcmurraybio.gla.ac.uk

Abstract

Objective: To examine the epidemiology, primary care burden, and treatment of heart failure in Scotland, UK.

Design: Cross sectional data from primary care practices participating in the Scottish continuous morbidity recording scheme between 1 April 1999 and 31 March 2000.

Setting: 53 primary care practices (307 741 patients).

Subjects: 2186 adult patients with heart failure.

Results: The prevalence of heart failure in Scotland was 7.1 in 1000, increasing with age to 90.1 in 1000 among patients ⩾ 85 years. The incidence of heart failure was 2.0 in 1000, increasing with age to 22.4 in 1000 among patients ⩾ 85 years. For older patients, consultation rates for heart failure equalled or exceeded those for angina and hypertension. Respiratory tract infection was the most common co-morbidity leading to consultation. Among men, 23% were prescribed a β blocker, 11% spironolactone, and 46% an angiotensin converting enzyme inhibitor. The corresponding figures for women were 20% (p  =  0.29 versus men), 7% (p  =  0.02), and 34% (p < 0.001). Among patients < 75 years 26% were prescribed a β blocker, 11% spironolactone, and 50% an angiotensin converting enzyme inhibitor. The corresponding figures for patients ⩾ 75 years were 19% (p  =  0.04 versus patients < 75), 7% (p  =  0.04), and 33% (p < 0.001).

Conclusions: Heart failure is a common condition, especially with advancing age. In the elderly, the community burden of heart failure is at least as great as that of angina or hypertension. The high rate of concomitant respiratory tract infection emphasises the need for strategies to immunise patients with heart failure against influenza and pneumococcal infection. Drugs proven to improve survival in heart failure are used less frequently for elderly patients and women.

  • ACE, angiotensin converting enzyme
  • ARB, angiotensin receptor blocker
  • CMR, continuous morbidity recording
  • EPICA, epidemiologia da insuficiěncia cardiaca a aprendizagen
  • NHANES, national health and nutrition examination survey
  • OR, odds ratio
  • heart failure
  • epidemiology
  • prescribing
  • primary care

Statistics from Altmetric.com

Footnotes

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.