title: Diagnosis and treatment of heart failure in primary health care among elderly patients with non-insulin-dependent diabetes mellitus, with special reference to use of echocardiography.
abstract: OBJECTIVE
  The aim of the present study was to describe how the diagnosis of heart failure (HF) was assessed, aetiology and management in elderly patients with non-insulin-dependent diabetes mellitus (NIDDM) in primary health care, with special reference to use of echocardiography.
  
  
  METHODS
  Descriptive retrospective investigation.
  
  
  METHODS
  Ronneby and Karlskrona communities, both situated on the Swedish south-east coast, 28,600 and 60,600 inhabitants, respectively.
  
  
  METHODS
  279 patients with NIDDM, mean age 77 years (range 70-85).
  
  
  METHODS
  Prevalence, aetiology, diagnostic procedures and management of HF.
  
  
  RESULTS
  The majority of patients were given the diagnosis of HF mainly as a result of clinical examination, ECG and chest X-ray, or of hospitalisation for HF. The diagnosis of HF by the primary care physicians was based on an objective evaluation of cardiac function in 8% of the patients. Hypertension was the predominant associated disease, followed by ischaemic heart disease (IHD). Therapy included diuretics (91%), angiotensin-converting enzyme (ACE) inhibitors (43%) and digoxin (53%).
  
  
  CONCLUSIONS
  There is still a gap between current management of HF in primary care and guidelines, particularly in the case of diagnosis that is not generally based on an objective evaluation of cardiac function.
authors.affiliation: Blekinge Institute for Research & Development, Karlshamn, Sweden. anders.halling@ltblekinge.se
authors.forename: Anders
authors.initials: A
authors.lastname: Halling
authors.forename: Johan
authors.initials: J
authors.lastname: Berglund
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D011320:Primary Health Care / Q000458:organization & administration*; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology