The Prevalence of Stages of Heart Failure in Primary Care: A Population-Based Study

The Prevalence of Stages of Heart Failure in Primary Care: A Population-Based Study

Abstract Background Planning strategies to prevent heart failure (HF) in developing countries require epidemiologic data in primary care. The purpose of this study was to estimate the prevalence of HF stages and their phenotypes, HF with preserved ejection fraction (HFPEF), and HF with reduced EF (H...

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Published in:Journal of cardiac failure Vol. 22; no. 2; pp. 153 - 157
Main Authors: Jorge, Antonio Lagoeiro, MSc, Rosa, Maria Luiza G, Martins, Wolney A, Correia, Dayse Mary S, Fernandes, Luiz Claudio M, Costa, Jean A, Moscavitch, Samuel D, Jorge, Bruno Afonso L, Mesquita, Evandro T
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-02-2016
Subjects:
Aged
Aged, 80 and over
Brazil - epidemiology
Cardiovascular
Cross-Sectional Studies
Echocardiography
Echocardiography, Doppler
Electrocardiography
Epidemiology
Female
Heart failure
Heart Failure - diagnosis
Heart Failure - diagnostic imaging
Heart Failure - epidemiology
Humans
Male
Middle Aged
Natriuretic Peptide, Brain - blood
Natriuretic peptides
Prevalence
Primary Health Care - statistics & numerical data
Stroke Volume
Heart failure
Prevalence
Echocardiography
Epidemiology
Natriuretic peptides
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Summary:Abstract Background Planning strategies to prevent heart failure (HF) in developing countries require epidemiologic data in primary care. The purpose of this study was to estimate the prevalence of HF stages and their phenotypes, HF with preserved ejection fraction (HFPEF), and HF with reduced EF (HFREF) and to determine B-type natriuretic peptide (BNP) levels to identify HF in the adult population. Methods and Results This is a cross-sectional study including 633 individuals, aged ≥45 years, who were randomly selected and registered in a primary care program of a medium-sized city in Brazil. All participants were underwent clinical evaluations, BNP measurements, electrocardiograms, and tissue Doppler echocardiography in a single day. The participants were classified as stage 0 (healthy, 11.7%), stage A (risk factors, 36.6%), stage B (structural abnormalities, 42.7%), or stage C (symptomatic HF, 9.3%). Among patients with HF, 59% presented with HFPEF and 41% presented with HFREF. The mean BNP levels were 20 pg/mL−1 in stage 0, 20 pg/mL−1 in stage A, 24 pg/mL−1 in stage B, 93 pg/mL−1 in HFPEF, and 266 pg/mL−1 in HFREF. The cutoff BNP level with optimal sensitivity (92%) and specificity (91%) to identify HF was 42 pg/mL−1. Conclusion The present study demonstrated a high prevalence of individuals at risk for HF and the predominance of HFPEF in a primary care setting. The clinical examination, along with BNP and tissue Doppler echocardiography, may facilitate early detection of stages A and B HF and allow implementation of interventions aimed at preventing progression to symptomatic HF.
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ISSN:1071-9164
1532-8414
DOI:10.1016/j.cardfail.2015.10.017