Detection of unrecognized clinical heart failure in elderly hypertensive women attended in primary care setting.
OBJECTIVE
To determine the proportion and clinical features of unrecognized heart failure (HF) in hypertensive women ≥65 years attended in Spain.


METHODS
A cross-sectional study carried out in primary healthcare setting. Patients were considered to present unrecognized clinical diagnosis of HF if they had not been previously diagnosed but fulfilled Framingham criteria for HF diagnosis.


RESULTS
Of 3500 patients, the proportion of unrecognized clinical HF was 26.3%. In comparison with women without HF, all cardiovascular risk factors were more prevalent in patients with unrecognized HF; the same was observed for target organ damage, being the most frequent left ventricular hypertrophy (LVH) (54.1% vs 15.5%, p<0.0001), and for the presence of cardiovascular disease, being the most common coronary heart disease (24.8% vs 9.8%, p<0.0001). Predictive factors associated with the presence of unrecognized HF were LVH (OR =4.84) and the presence of previous cardiovascular disease (OR =2.26) Blood pressure control was worse in patients with unrecognized HF (16.6% vs 33.9%, p <0.01).


CONCLUSIONS
More than a quarter of hypertensive women ≥65 years may have clinical data of unrecognized HF. Hypertensive women with unrecognized clinical HF have a worse clinical profile and worse BP control rates than those without HF.
Barrios
Vivencio
V
Cardiology Department, Hospital Ramón y Cajal, Madrid, Spain. vbarriosa@meditex.es
Escobar
Carlos
C
De La Sierra
Alex
A
Llisterri
José Luis
JL
González-Segura
Diego
D
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular; D012307:Risk Factors; D013030:Spain