[Clinical characteristics of patients diagnosed of chronic heart failure attended in Primary Care. The CARDIOPRES study]. / Características clínicas de los pacientes diagnosticados de insuficiencia cardíaca crónica asistidos en Atención Primaria. Estudio CARDIOPRES.

INTRODUCTION: Scarce information is available on the clinical characteristics and risk factors of patients with chronic heart failure (CHF) attended in Primary Care (PC) setting. The aim of this study was to analyze the clinical characteristics of this population in PC. PATIENTS AND METHODS: Multicenter, cross-sectional study in patients with CHF, consecutively recruited by 232 physicians in PC. The collected data included sociodemographic, etiologic, clinical and therapeutic variables. RESULTS: Eight hundred forty seven (847) patients were included (age 73.0 +/- 9.6 years; 50.5% men). Of these, 84.3% had arterial hypertension (AHT), 59.2% hypercholesterolemia and 34.9% diabetes mellitus. The most frequent associated clinical disorders were ischemic heart disease (40.1%) and peripheral artery disease (28.6%). In 69.6% of the patients the physicians knew the type of dysfunction (32.4% systolic, 37.2% diastolic). The main etiologies of CHF were the hypertensive cardiomyopathy (75.0%) and ischemic heart disease (40.1%); the most frequent trigger factor was atrial fibrillation (43.9%). Loop diuretics (72.3%) and angiotensin-converting enzyme inhibitors (60.9%) were the treatments used most and 6.7% of the patients were receiving treatment with beta blockers. CONCLUSIONS: AHT appears to be primary cause of CHF in PC. Diastolic dysfunction is more frequent than the systolic one, and the PC physicians do not know the cause of the ventricular dysfunction in one third of the cases. Loop diuretics and angiotensin-converting enzyme inhibitors were the most frequently used in these patients; the use of beta blockers in CHF is very scarce in PC.

Características clínicas de los pacientes diagnosticados de insuficiencia cardíaca crónica asistidos en Atención Primaria. Estudio CARDIOPRES / Clinical characteristics of patients diagnosed of chronic heart failure attended in Primary Care. The CARDIOPRES study

Introducción. Se dispone de escasa información sobre las características clínicas de los pacientes con insuficiencia cardíaca crónica (ICC) asistidos en Atención Primaria (AP). El objetivo de este estudio fue analizar las características clínicas de estos enfermos en AP. Pacientes y métodos. Estudio multicéntrico y transversal realizado en pacientes con ICC reclutados consecutivamente por 232 médicos de AP. Se recogieron datos sociodemográficos, etiológicos, clínicos y terapéuticos. Resultados. Se incluyeron 847 pacientes (el 50,5% hombres) con una edad media de 73,0 ± 9,6 años. El 84,3% padecía hipertensión arterial (HTA), el 59,2% hipercolesterolemia y el 34,9% diabetes mellitus. Los trastornos clínicos asociados más frecuentes fueron la cardiopatía isquémica (40,1%) y la arteriopatía periférica (28,6%). En el 69,6% los médicos conocían el tipo de disfunción (el 32,4% sistólica; el 37,2% diastólica). Las principales causas de ICC fueron la cardiopatía hipertensiva (75,0%) y la cardiopatía isquémica (40,1%); el factor desencadenante más frecuente de la aparición de ICC fue la fibrilación auricular (43,9%). Los fármacos más utilizados en el tratamiento fueron los diuréticos de asa (72,3%) y los inhibidores de la enzima convertidora de la angiotensina (60,9%); el 6,7% de los pacientes recibía tratamiento con bloqueadores beta. Conclusiones. La principal causa de ICC en AP es la HTA, la disfunción diastólica es más frecuente que la sistólica y en una tercera parte de los casos el médico desconoce el tipo de disfunción. Diuréticos de asa e inhibidores de la enzima convertidora de la angiotensina son los fármacos más frecuentemente prescritos en estos pacientes; la prescripción de bloqueadores beta es muy pobre (AU)

Introduction. Scarce information is available on the clinical characteristics and risk factors of patients with chronic heart failure (CHF) attended in Primary Care (PC) setting. The aim of this study was to analyze the clinical characteristics of this population in PC. Patients and methods. Multicenter, cross-sectional study in patients with CHF, consecutively recruited by 232 physicians in PC. The collected data included sociodemographic, etiologic, clinical and therapeutic variables. Results. Eight hundred forty seven (847) patients were included (age 73.0 ± 9.6 years; 50.5% men). Of these, 84.3% had arterial hypertension (AHT), 59.2% hypercholesterolemia and 34.9% diabetes mellitus. The most frequent associated clinical disorders were ischemic heart disease (40.1%) and peripheral artery disease (28.6%). In 69.6% of the patients the physicians knew the type of dysfunction (32.4% systolic, 37.2% diastolic). The main etiologies of CHF were the hypertensive cardiomyopathy (75.0%) and ischemic heart disease (40.1%); the most frequent trigger factor was atrial fibrillation (43.9%). Loop diuretics (72.3%) and angiotensin-converting enzyme inhibitors (60.9%) were the treatments used most and 6.7% of the patients were receiving treatment with beta blockers. Conclusions. AHT appears to be primary cause of CHF in PC. Diastolic dysfunction is more frequent than the systolic one, and the PC physicians do not know the cause of the ventricular dysfunction in one third of the cases. Loop diuretics and angiotensin-converting enzyme inhibitors were the most frequently used in these patients; the use of beta blockers in CHF is very scarce in PC (AU)