Patients in primary health care diagnosed and treated as heart failure, with special reference to gender differences.
OBJECTIVE
The aim of the present study was to describe patients considered to have had heart failure (HF), or were being treated for HF, in a defined area in primary health care, e.g. diagnostic procedures, aetiologic diseases and management, and to evaluate whether there is a difference between the genders.


METHODS
Descriptive retrospective investigation.


METHODS
Atvidaberg community situated in southeast Sweden, 12 400 inhabitants.


METHODS
256 patients treated for symptomatic HF.


METHODS
Prevalence, aetiology, diagnostic procedures and management of HF and differences between the genders.


RESULTS
The diagnosis of HF was based on an objective evaluation of cardiac function in only 31% of the patients. Ischaemic heart disease (IHD) was the predominant associated disease, followed by hypertension. Therapy included diuretics (84%), angiotensin converting enzyme (ACE) inhibitors (56%) and digoxin (40%). Only 52% had optimal doses of ACE inhibitors. Women had a significantly higher mean age and their diagnoses were based on an objective diagnostic test (echocardiography) in only 20%. Women were prescribed ACE inhibitors to a lesser extent (43%) than men (64%) and with a lower optimal dose (44% versus 56% in men).


CONCLUSIONS
There is still room for improvement in the management of HF in primary health care, especially in women, where the diagnosis is not generally based on an objective evaluation of cardiac function and where the treatment to a lesser extent than in men includes ACE inhibitors.
Agvall
B
B
Health Care Centre of Atvidaberg, Linköping University Hospital, Sweden.
Dahlström
U
U
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002303:Cardiac Output, Low / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D004077:Digoxin / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications; D011320:Primary Health Care / Q000592:standards*; D012189:Retrospective Studies; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology; D016387:Women's Health
D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D004077:Digoxin