Ambulatory heart failure management in private practice in France.
Management of ambulatory heart failure was assessed in a group of 600 patients, mean age 73, 64% males, NYHA I: 9%; II: 52%; III: 33%; IV: 6%; followed up by a representative sample of private cardiologists. Fifty-two percent of patients had been previously hospitalised for worsening heart failure with a mean duration of stay of 13.1 days, for those hospitalised in the year preceding the survey (26%). First diagnosis of heart failure had been performed by a cardiologist (57%), a general practitioner (37%) or another category of physician (6%). Seventy percent of patients received three or more different classes of heart failure medications. Diuretics were prescribed to 71%, angiotensin converting enzyme inhibitors to 54% and digitalis to 35% of the population. Beta-blockers were given to only 14% of the patients. In patients aged over 80 years, only 45% received angiotensin converting enzyme inhibitors.


CONCLUSIONS
This survey of ambulatory heart failure patients confirms that the disease is predominantly observed in elderly patients, and associated with prolonged and recurrent hospitalisations. The underuse of recommended therapeutic classes including angiotensin converting enzyme inhibitors and beta-blockers deserves further investigation.
Komajda
M
M
Service de Cardiologie, Hôpital Pitié Salpétrière, 47-83 Bd de l'Hôpital, 75013 Paris, France. michel.komajda@psl.ap-hop-paris.fr
Bouhour
J B
JB
Amouyel
P
P
Delahaye
F
F
Vicaut
E
E
Croce
I
I
Rougemond
E
E
Vuittenez
F
F
Leutenegger
E
E
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods*; D002309:Cardiology / Q000379:methods* / Q000706:statistics & numerical data; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D005260:Female; D005602:France / Q000453:epidemiology; D019538:Health Care Surveys; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011331:Private Practice / Q000706:statistics & numerical data*; D012307:Risk Factors; D012494:Sampling Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate; D016896:Treatment Outcome
D002316:Cardiotonic Agents