title: Health-related quality of life and stages of heart failure.
abstract: BACKGROUND
  To estimate the impact on quality of life of evolving stages of heart failure in a community sample of Portuguese adults.
  
  
  METHODS
  Cross-sectional evaluation of 424 adults aged >/=45 years. Subjects were classified in stages defined by the American College of Cardiology: low risk, high risk for heart failure (stage A), asymptomatic cardiac dysfunction (stage B), symptomatic heart failure (stage C). Quality of life was assessed using 8 sub-domains of Short Form 36: physical functioning, role limitations-physical problems, bodily pain, general health perception, social functioning, vitality, role limitations-emotional problems and mental health.
  
  
  RESULTS
  Women scored significantly lower on all sub-domains. Quality of life decreased with age and increased with socioeconomic status. Adjusting for gender, age and education, physical sub-domains, general health perception, social functioning and role limitations-emotional problems decreased significantly with increasingly severe heart failure stages in women and men. No significant association was found with vitality and mental health.
  
  
  CONCLUSIONS
  Significantly lower scores on quality of life sub-domains were found across increasing severity of heart failure stages, even in the early asymptomatic phases. The results contradict conceptual frameworks which suggest that the impact of heart failure on quality of life depends on symptoms.
authors.affiliation: Department of Hygiene and Epidemiology, University of Porto Medical School, Portugal; Heart Failure Clinic, Department of Medicine, Hospital de S. João, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Azevedo
authors.forename: Paulo
authors.initials: P
authors.lastname: Bettencourt
authors.forename: Margarida
authors.initials: M
authors.lastname: Alvelos
authors.forename: Elisabete
authors.initials: E
authors.lastname: Martins
authors.forename: Cassiano
authors.initials: C
authors.lastname: Abreu-Lima
authors.forename: Hans-Werner
authors.initials: HW
authors.lastname: Hense
authors.forename: Henrique
authors.initials: H
authors.lastname: Barros
mesh_terms: D000367:Age Factors; D000886:Anthropometry; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011174:Portugal / Q000453:epidemiology; D011581:Psychological Tests; D011594:Psychometrics; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires