title: Heart failure with preserved ejection fraction and systolic dysfunction in the community.
abstract: BACKGROUND
  In developed countries, heart failure with preserved ejection fraction (HFpEF) is more prevalent than heart failure with reduced ejection fraction (HFrEF) in the community. However, it has not been completely established if this fact is also observed within our community.
  
  
  OBJECTIVE
  To determine the most prevalent form of heart failure (HFpEF or HFrEF) and whether the prevalence of HFpEF is higher in the community.
  
  
  METHODS
  This is a cross-sectional study conducted with patients clinically diagnosed with HF who were seen in community-based health care centers from January to December 2005. Echodopplercardiograms were performed for all patients. The form of HF was stratified according to the presence of abnormalities and the shortening fraction observed on the echodopplercardiogram.
  
  
  RESULTS
  The study evaluated 170 patients (61.0 +/- 13.3 years of age), most of them women and elderly. HFpEF was the more prevalent form of HF (64.2%, p<0.001), affecting mostly elderly women (62%, p = 0.07), whereas the opposite condition, HFrEF, was observed mostly in elderly men (63.6%, p = 0.07). Patients with no HF represented one-third of the cases (27.6%). HFrEF patients had more lower-limb edema, coronary disease, diabetes, chronic renal failure, higher Boston scores and hospital readmissions. Use of alcoholic beverages and smoking were also more common among HFrEF patients.
  
  
  CONCLUSIONS
  HFpEF is the most prevalent form of HF in the community especially among elderly women, whereas HFrEF affects mostly elderly men and is associated with greater clinical severity, main risk factors and no changes in lifestyle. Despite the signs and symptoms of HF, this condition was not confirmed for one-third of the cases.
authors.affiliation: Universidade Federal Fluminense, Fundação Municipal de Saúde de Niterói - Programa Médico de Família, Niterói, RJ - Brazil. maesposito@cardiol.br
authors.forename: Marco Aurélio Esposito
authors.initials: MA
authors.lastname: Moutinho
authors.forename: Flávio Augusto
authors.initials: FA
authors.lastname: Colucci
authors.forename: Veronica
authors.initials: V
authors.lastname: Alcoforado
authors.forename: Leandro Reis
authors.initials: LR
authors.lastname: Tavares
authors.forename: Mauricio Bastos Freitas
authors.initials: MB
authors.lastname: Rachid
authors.forename: Maria Luisa Garcia
authors.initials: ML
authors.lastname: Rosa
authors.forename: Mário Luiz
authors.initials: ML
authors.lastname: Ribeiro
authors.forename: Rosemery
authors.initials: R
authors.lastname: Abdalah
authors.forename: Juliana Lago
authors.initials: JL
authors.lastname: Garcia
authors.forename: Evandro Tinoco
authors.initials: ET
authors.lastname: Mesquita
mesh_terms: D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D004487:Edema / Q000000981:diagnostic imaging / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D035002:Lower Extremity / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D014463:Ultrasonography