Adequacy of diagnosis and treatment of chronic heart failure in primary health care in Sweden

Aims We performed an observational multicentre study to obtain information of the diagnostic tools and treatments currently used in patients with chronic heart failure (CHF) in primary health care (PHC) in Sweden. Data were collected from 2093 patients in 158 randomly selected PHC centres. Methods a...

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Bibliographic Details
Published in:European journal of heart failure Vol. 11; no. 1; pp. 92 - 98
Main Authors: Dahlstrom, Ulf, Hakansson, Jan, Swedberg, Karl, Waldenstrom, Anders
Format: Journal Article
Language:English
Published: England Blackwell Publishing Ltd 01.01.2009
Oxford University Press
Subjects:
80 and over
Aged
Aged, 80 and over
Cardiology and Cardiovascular Disease
Chronic Disease
Comorbidity
Diagnosis
Female
Heart failure
Heart Failure - diagnosis
Heart Failure - drug therapy
Heart Failure - epidemiology
Heart Failure - etiology
Heart Failure/diagnosis/drug therapy/epidemiology/etiology
Humans
Kardiologi och kardiovaskulära sjukdomar
Male
MEDICIN
MEDICINE
Middle Aged
Physician's Practice Patterns/statistics & numerical data
Practice Patterns, Physicians' - statistics & numerical data
Primary Health Care
Renin-Angiotensin System - drug effects
Retrospective Studies
Sweden
Treatment
Sweden
Heart failure
Treatment
Diagnosis
Primary health care
ISSN:1388-9842, 1879-0844, 1879-0844
Online Access:Get full text
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Summary:Aims We performed an observational multicentre study to obtain information of the diagnostic tools and treatments currently used in patients with chronic heart failure (CHF) in primary health care (PHC) in Sweden. Data were collected from 2093 patients in 158 randomly selected PHC centres. Methods and results The mean age was 79 years. The dominating aetiology of HF was hypertension and/or ischaemic heart disease. Diagnosis was based on symptoms and/or ECG and/or chest X-ray in 69% of the patients. Treatment with a renin-angiotensin system (RAS) blocker was ongoing in 74% of the patients, but only 37% had ≥50% of the recommended target dose. In 68%, treatment with a beta-blocker (BB) was present, but only 31% had ≥50% of the recommended target dose. Only 42% of the patients were on treatment with an RAS blocker and a BB and only 20% had ≥50% of the recommended target dose. Conclusion The diagnostic criteria for CHF according to the European Society of Cardiology were fulfilled in only ∼30% of the patients. In addition, evidenced-based treatments to reduce morbidity and mortality were markedly underused, particularly regarding dosing. Our findings may reflect the patients' high age and the presence of important co-morbidities.
Bibliography:istex:DF3736847CEA13E593AAA0FFDF580FC3293CED01
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ArticleID:EJHFHFN006
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ISSN:1388-9842
1879-0844
1879-0844
DOI:10.1093/eurjhf/hfn006