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. 2024 May 7;54(7):1478-1487.
doi: 10.55730/1300-0144.5934. eCollection 2024.

Burden of comorbidities in heart failure patients in Türkiye

Yüksel Çavuşoğlu  1 , Selda Murat  1 , Anıl Şahin  2 , İnci Tuğçe Çöllüoğlu  3 , Dilek Ural  4 , Mehmet Birhan Yilmaz  5 , Sanem Nalbantgil  6 , Naim Ata  7 , Mustafa Mahir Ülgü  7 , Şuayip Birinci  8 , Emre Demir  6 , Emine Arzu Kanik  9 , Lale Dinç Asarcikli  10 , Ahmet Çelik  11
Affiliations

Burden of comorbidities in heart failure patients in Türkiye

Yüksel Çavuşoğlu et al. Turk J Med Sci. .

Abstract

Background/aim: Heart failure (HF) is associated with a wide range of comorbidities that negatively impact clinical outcomes and cause high economic burden. We aimed to evaluate the frequency and burden of comorbidities in HF patients in Türkiye and their relationships with patients' demographic characteristics.

Materials and methods: Based on ICD-10 codes in the national electronic database of the Turkish Ministry of Health covering the entire population of Türkiye (n = 85,279,553) from 1 January 2016 to 31 December 2022, data on the prevalence of comorbidities in HF patients were obtained. The frequency and burden of comorbidities were analyzed separately by age groups, sex, and socioeconomic status (SES).

Results: Between 2016 and 2022, there were 2,722,151 patients (51.7% female) of all ages who were diagnosed with HF. In Türkiye, the most common comorbidities of HF patients were hypertension (HT) (97.6%), atherosclerotic cardiovascular disease (ASCVD) (84.9%), dyslipidemia (59.5%), anxiety disorder (48.1%), diabetes mellitus (DM) (45.2%), chronic obstructive pulmonary disease (COPD) (43.6%), anemia (40.6%), and atrial fibrillation (AF) (37.1%). Female patients had higher rates of anemia, DM, HT, and anxiety disorders, while male patients had higher rates of ASCVD, COPD, and dyslipidemia. The most common comorbidity in patients under 20 years of age was congenital heart disease (52.3%). More than 90% of HF patients had ≥2 comorbidities. HF patients with ≥5 comorbidities increased from 18.1% in the group aged 20-49 years to 38.3% in the group aged 50-79 years. Comorbidities were similar across SES groups.

Conclusion: The most common comorbidities in cases of HF in Türkiye are HT, ASCVD, dyslipidemia, DM, COPD, anemia, and AF, respectively, and more than 90% of patients have ≥2 comorbidities. While ASCVD and dyslipidemia were more common in male patients, anemia, DM, and anxiety disorders were more common in female patients. The number of comorbid conditions increased with advanced age.

Keywords: Comorbidity; comorbidity burden; electronic health records; heart failure.

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Conflict of interest statement

Conflict of interest: The authors declare that there is no conflict of interest regarding the publication of this manuscript.

Figures

Figure 1
Figure 1
Unadjusted comparison of male and female patients according to the frequency of comorbidities in heart failure. COPD: Chronic obstructive pulmonary disease; HD: heart disease; MI: myocardial infarction; PTE: pulmonary embolism. Odds ratios of >1 indicate a greater prevalence of the condition among female patients, whereas odds ratios of <1 indicate a greater prevalence of the condition among male patients.
Figure 2
Figure 2
Comorbidity burden of patients with heart failure by age groups.
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