Characteristics and outcomes of patients with heart failure in general practices and hospitals

Circ J. 2007 Apr;71(4):449-54. doi: 10.1253/circj.71.449.

Abstract

Background: The characteristics and outcomes of patients discharged from hospitals with a diagnosis of heart failure (HF) have been described by a number of previous epidemiological studies. However, very little information is available on this issue in general practice in Japan.

Methods and results: The Japanese Cardiac Registry of Heart Failure in General Practice (JCARE-GENERAL) is designed to study the characteristics, treatment and outcomes prospectively in a broad sample of outpatients with HF who were managed by cardiologists in hospital (Hospital-HF) and primary care physicians in general practice (GP-HF). Out of 2,685 patients with HF, 1,280 patients were Hospital-HF and 1,405 GP-HF. Compared to the Hospital-HF patients, GP-HF patients were more likely to be elderly and female, and they had a higher prevalence of hypertensive heart disease as a cause of HF. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and beta-blockers were more prescribed to Hospital-HF than GP-HF patients. At the follow-up of 1.2 year, after adjustment, the mortality was comparable between the Hospital-HF and GP-HF groups, whereas HF-related admission was higher in the Hospital-HF group than in in the GP-HF group.

Conclusions: Based on the JCARE-GENERAL, the characteristics, treatment and outcomes of GP-HF patients differed from those of Hospital-HFpatients in Japan.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenergic beta-Antagonists / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Cardiac Output, Low / drug therapy*
  • Cardiac Output, Low / mortality
  • Cardiac Output, Low / physiopathology*
  • Cardiology / statistics & numerical data
  • Digitalis Glycosides / therapeutic use
  • Diuretics / therapeutic use
  • Family Practice / statistics & numerical data
  • Female
  • Hospitals / statistics & numerical data
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Patient Readmission / statistics & numerical data
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Prospective Studies
  • Registries / statistics & numerical data
  • Treatment Outcome

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin II Type 1 Receptor Blockers
  • Angiotensin-Converting Enzyme Inhibitors
  • Digitalis Glycosides
  • Diuretics