RT Journal Article
SR Electronic
T1 Characteristics of patients with heart failure with preserved ejection fraction in primary care: a cross-sectional analysis
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP BJGPO.2021.0094
DO 10.3399/BJGPO.2021.0094
VO 5
IS 6
A1 Forsyth, Faye
A1 Brimicombe, James
A1 Cheriyan, Joseph
A1 Edwards, Duncan
A1 Hobbs, FD Richard
A1 Jalaludeen, Navazh
A1 Mant, Jonathan
A1 Pilling, Mark
A1 Schiff, Rebekah
A1 Taylor, Clare J
A1 Zaman, M Justin
A1 Deaton, Christi
A1 on behalf of the OPTIMISE HFpEF investigators and collaborators
YR 2021
UL http://bjgpopen.org/content/5/6/BJGPO.2021.0094.abstract
AB Background Many patients with heart failure with preserved ejection fraction (HFpEF) are undiagnosed, and UK general practice registers do not typically record heart failure (HF) subtype. Improvements in management of HFpEF is dependent on improved identification and characterisation of patients in primary care.Aim To describe a cohort of patients recruited from primary care with suspected HFpEF and compare patients in whom HFpEF was confirmed and refuted.Design & setting Baseline data from a longitudinal cohort study of patients with suspected HFpEF recruited from primary care in two areas of England.Method A screening algorithm and review were used to find patients on HF registers without a record of reduced ejection fraction (EF). Baseline evaluation included cardiac, mental and physical function, clinical characteristics, and patient reported outcomes. Confirmation of HFpEF was clinically adjudicated by a cardiologist.Results In total, 93 (61%) of 152 patients were confirmed HFpEF. The mean age of patients with HFpEF was 79 years, 46% were female, 80% had hypertension, and 37% took ≥10 medications. Patients with HFpEF were more likely to be obese, pre-frail or frail, report more dyspnoea and fatigue, were more functionally impaired, and less active than patients in whom HFpEF was refuted. Few had attended cardiac rehabilitation.Conclusion Patients with confirmed HFpEF had frequent multimorbidity, functional impairment, frailty, and polypharmacy. Although comorbid conditions were similar between people with and without HFpEF, the former had more obesity, symptoms, and worse physical function. These findings highlight the potential to optimise wellbeing through comorbidity management, medication rationalisation, rehabilitation, and supported self-management.