title: Prevalence of heart failure with preserved ejection fraction in Latin American, Middle Eastern, and North African Regions in the I PREFER study (Identification of Patients With Heart Failure and PREserved Systolic Function: an epidemiological regional study).
abstract: The aims of the present study were to estimate the prevalence of heart failure (HF) with preserved ejection fraction (HF-PEF) in patients with HF and to compare their clinical characteristics with those with reduced ejection fraction in non-Western countries. The left ventricular ejection fraction ≥ 45% if measured < 1 year before the visit was used to qualify the patients as having HF-PEF. Of the 2,536 consecutive outpatients with HF, 1990 (79%) had the EF values recorded. Of these patients, 1291 had HF-PEF, leading to an overall prevalence of 65% (95% confidence interval 63% to 67%). Compared to the patients with HF and a reduced ejection fraction, those with HF-PEF were more likely to be older (65 vs 62 years, p < 0.001), female (50% vs 28%, p < 0.001), and obese (39% vs 27%, p < 0.001). They more frequently had a history of hypertension (78% vs 53%, p < 0.001) and atrial fibrillation (29% vs 24%, p = 0.03) and less frequently had a history of myocardial infarction (21% vs 44%, p < 0.001). Only 29% of patients with HF-PEF and hypertension had optimal blood pressure control. Left ventricular hypertrophy was less frequent in those with HF-PEF (58% vs 69%, p < 0.001). The prevalence of HF-PEF was lower in the Middle East (41%), where coronary artery disease was more often found than in Latin America (69%) and North Africa (75%), where the rate of hypertension was greater. In conclusion, in the present diverse non-Western study, HF-PEF represented almost 2/3 of all HF cases in outpatients. HF-PEF mostly affects older patients, women, and the obese. Hypertension was the most frequently associated risk factor, highlighting the need for optimal blood pressure control.
authors: Centro Médico Nacional Siglo XXI, Mexico City, Mexico.
authors: José A
authors: JA
authors: Magaña-Serrano
authors: Wael
authors: W
authors: Almahmeed
authors: Efrain
authors: E
authors: Gomez
authors: Mostafa
authors: M
authors: Al-Shamiri
authors: Djamila
authors: D
authors: Adgar
authors: Philippe
authors: P
authors: Sosner
authors: Daniel
authors: D
authors: Herpin
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000352:Africa, Northern / Q000453:epidemiology; D017677:Age Distribution; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000453:epidemiology; D009202:Cardiomyopathies / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D000451:Mineralocorticoid Receptor Antagonists; D009203:Myocardial Infarction / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D017678:Sex Distribution; D013318:Stroke Volume
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists