12/17/2022 0 Comments Ivcd 800 339 2402These data are essential to the understanding of potential differences between patients with CHF in the community and those commonly studied in CHF therapeutic trials and to the determination of whether recommendations from these trials have an impact on the management and outcome of CHF in the community. Furthermore, few data are available regarding the use of therapeutic agents in the community. In the community setting, it is unknown how many patients with CHF have normal systolic function and whether their clinical characteristics and prognosis are unique. 13 Most of the previous studies were small and subject to referral bias. 8 9 10 11 12 There has been considerable interest in isolated diastolic dysfunction in recent years, and several studies have reported that a substantial number of patients with CHF have normal systolic function. Limited data are available about the characterization and prognosis of CHF in the community. 6 7 Most studies that have characterized patients with CHF include only patients with systolic left ventricular dysfunction and are limited by significant referral bias because they often focus on hospital-based practices or patients referred to a tertiary center and generally have excluded very elderly patients. 5 Furthermore, as the US population becomes older, the prevalence of CHF may continue to increase. Approximately 2 million persons in the United States have CHF every year there are 400 000 new cases 4 and 274 000 deaths. 3 This condition is associated with high morbidity and mortality. 1 2 In contrast, congestive heart failure (CHF) is the only common cardiovascular condition whose prevalence is increasing, particularly in elderly patients. Diagnostic and therapeutic methods are underused in the community.ĭuring the past 25 years, death rates for cardiovascular disease have been decreasing in western countries. CHF is a disease of the “very elderly,” frequently occurs in the setting of normal ejection fraction, and has a poor prognosis, regardless of the level of systolic function. ACE inhibitors were used in only 44% of the total population with CHF.Ĭonclusions-The present study reports the clinical characteristics and natural history of CHF as it presents in the community in the vasodilator era. Survival adjusted for age, sex, NYHA class, and coronary artery disease was not significantly different between patients with preserved and those with reduced systolic function (relative risk, 0.80 P=0.369). In these patients, systolic function was preserved (ejection fraction ≥50%) in 59 (43%) and reduced (ejection fraction <50%) in 78 (57%). Of the 216 patients, 137 (63%) had an assessment of ejection fraction. The prognosis of patients with a new diagnosis of CHF was poor survival was 86☒% at 3 months, 76☓% at 1 year, and 35☓% at 5 years. Among these patients, 88% were ≥65 years and 49% were ≥80 years of age. Methods and Results-Using the resources of the Rochester Epidemiology Project, we evaluated all patients receiving a first diagnosis of CHF in Olmsted County, Minnesota, in 1991 (n=216). Customer Service and Ordering Informationīackground-Data are limited regarding the classification and prognosis of patients with congestive heart failure (CHF) in the community.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
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