Heart failure: a view from primary care

Objective: Our aim was to find out the situation of heart failure (HF) in primary care. Design: Cross-sectional multicentre study. Setting: Four primary health care centres and a hospital in an urban area of Barcelona. Participants: From a registered population of 35,212 inhabitants older than 45 years, we studied all patients (333) diagnosed with HF in 2006 in primary care. Measurements: A standardised questionnaire was used to record demographic, clinical and treatment data. Results: There were 61.4% females. Mean age was 74.5 (standard deviation [SD]: 10) for men and 79 (SD: 9.8) for women. A total of 46% of patients had HF for <5 years. The comorbidity diagnosis and at the beginning of the study were: hypertension 65.4% and 73%, diabetes 33.6% and 40%, dyslipaemia 40% and 53%, coronary disease 30% and 27%, and valvular disease 23.7% and 27%, respectively. A total of 64% of patients had registered New York Heart Association functional class (48% class 11, 30% 111 and 6.6% IV). Blood pressure was controlled in 36% men and 20.5% women (P = 0.002); 75.4% had an electrocardiogram, 57% X-ray; 58% of men and 46% of women (P = 0.02) had echocardiography. The most prescribed drugs were diuretics 85.3%, the least, beta blockers 27%. Conclusions: Patients with HF in primary care are elderly females with a lot of comorbidities. We must be concerned by the suboptimal use of basic investigations (electrocardiogram and X-ray) and beta blocker treatments. (C) 2004 Elsevier Espana, S.L All rights reserved.