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. 2019 Jan 7;9(1):e022972.
doi: 10.1136/bmjopen-2018-022972.

Burden of heart failure in Flemish general practices: a registry-based study in the Intego database

Miek Smeets  1 , Bert Vaes  1   2 , Pavlos Mamouris  1 , Marjan Van Den Akker  1   3 , Gijs Van Pottelbergh  1 , Geert Goderis  1 , Stefan Janssens  4 , Bert Aertgeerts  1 , Séverine Henrard  1   2
Affiliations

Burden of heart failure in Flemish general practices: a registry-based study in the Intego database

Miek Smeets et al. BMJ Open. .

Abstract

Objectives: To assess the prevalence and incidence of heart failure (HF) stages A to C/D and their evolution over a 16-year period. Additionally, trends in comorbidities and cardiovascular (CV) treatment in patients with HF were studied in the same period.

Design: Registry-based study.

Setting: Primary care, Flanders, Belgium.

Participants: Data were obtained from Intego, a morbidity registration network in which 111 general practitioners of 48 practices collaborate. In the study period between 2000 and 2015, data from 165 796 unique patients aged 45 years and older were available.

Outcome measures: Prevalence and incidence were calculated for HF stage A, B and C/D by gender. Additionally, the trend in age-standardised prevalence and incidence rates between 2000 and 2015 was analysed with joint-point regression. The same model was used to study trends in comorbidity profiles in incident HF cases and trends in cardiovascular medication in prevalent HF cases.

Results: We found a downward trend in the incidence and prevalence of HF stage C/D in Flemish general practice between 2000 and 2015, whereas the prevalence and incidence of stage A and B increased. The burden of comorbidities in incident HF cases increased during the study period, as shown by an increasing disease count (p<0.001). The prescription of cardiovascular medication such as renin-angiotensin-aldosterone system blockade, β-blockers and statins showed a sharp increase in the first part of the study period (2000-2008).

Conclusion: Age-standardised incidence and prevalence of HF stage C/D showed a slightly downward trend over the past 16 years, probably due to the sharp increase in cardiovascular treatment. However, the increasing age-standardised incidence and prevalence of stage A and B, as precursors of symptomatic HF, together with a rising comorbid burden, highlights the challenges we are still facing.

Keywords: epidemiology; heart failure; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Age-standardised prevalence of different heart failure stages 2000–2015.
Figure 2
Figure 2
Prevalence of different heart failure stages 2000–2015 per age group.
See this image and copyright information in PMC

References

    1. van den Akker M, Buntinx F, Metsemakers JF, et al. . Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol 1998;51:367–75. 10.1016/S0895-4356(97)00306-5 - DOI - PubMed
    1. Marengoni A, Rizzuto D, Wang HX, et al. . Patterns of chronic multimorbidity in the elderly population. J Am Geriatr Soc 2009;57:225–30. 10.1111/j.1532-5415.2008.02109.x - DOI - PubMed
    1. Field TS, Gurwitz JH, Harrold LR, et al. . Risk factors for adverse drug events among older adults in the ambulatory setting. J Am Geriatr Soc 2004;52:1349–54. 10.1111/j.1532-5415.2004.52367.x - DOI - PubMed
    1. Gijsen R, Hoeymans N, Schellevis FG, et al. . Causes and consequences of comorbidity: a review. J Clin Epidemiol 2001;54:661–74. 10.1016/S0895-4356(00)00363-2 - DOI - PubMed
    1. Hoffman C, Rice D, Sung HY. Persons with chronic conditions. Their prevalence and costs. JAMA 1996;276:1473–9. - PubMed

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