Non-cardiovascular co-morbidity in elderly patients with heart failure outnumbers cardiovascular co-morbidity.
BACKGROUND
Patients with heart failure often suffer from multiple co-morbid conditions. However, until now only cardiovascular co-morbidity has been well described.


OBJECTIVE
To understand heart failure in the context of multi-morbidity, by describing the age and sex specific patterns of non-cardiovascular co-morbidity in elderly patients with heart failure in general practice.


METHODS
All patients aged 65 years and over, diagnosed with heart failure in four practices of the Nijmegen Academic Practice-based Research Network (NPBRN) between January 1999 and December 2003 were selected, and the prevalence of 27 cardio- and non-cardiovascular co-morbidities determined.


RESULTS
Of the 269 patients identified (mean age 79 years; 57% women), 80.2% had four or more co-morbidities. With increasing age, a significant increase in the prevalence of non-cardiovascular conditions like visual and hearing impairments, osteoarthritis, dementia and urine incontinence; and a decrease in cardiovascular conditions like myocardial infarction and in women, hypertension, was observed. In patients aged 85 years and over, non-cardiovascular disorders predominated over cardiovascular disorders.


CONCLUSIONS
In elderly patients with heart failure, the prevalence of non-cardiovascular co-morbidity is very high and exceeds the prevalence of cardiovascular conditions. Diseases such as dementia and osteoarthritis must be taken into account in the management of elderly patients with heart failure.
van der Wel
Mark C
MC
Department of General Practice, Radboud University Nijmegen Medical Centre, The Netherlands. m.vanderwel@hag.umcn.nl <m.vanderwel@hag.umcn.nl>
Jansen
Rene W M M
RW
Bakx
J Carel
JC
Bor
Hans H J
HH
Olderikkert
Marcel G M
MG
van Weel
Chris
C
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D009426:Netherlands; D012042:Registries