title: Prevalence of preclinical and clinical heart failure in the elderly. A population-based study in Central Italy.
abstract: OBJECTIVE
  We conducted a population-based cross-sectional study to assess the prevalence of both preclinical and clinical heart failure (HF) in the elderly.
  
  
  RESULTS
  A sample of 2001 subjects, 65- to 84-year-old residents in the Lazio Region (Italy), underwent physical examination, biochemistry/N-terminal pro brain natriuretic peptide (NT-proBNP) assessment, electrocardiography, and echocardiography. Systolic left ventricular dysfunction (LVD) was defined as left ventricular ejection fraction (LVEF) <50%. Diastolic LVD was defined by a Doppler-derived multiparametric algorithm. The overall prevalence of HF was 6.7% [95% confidence interval (CI) 5.6-7.9], mainly due to HF with preserved LVEF (HFpEF) (4.9%; 95% CI 4.0-5.9), and did not differ by gender. A systolic asymptomatic LVD (ALVD) was detected more frequently in men (1.8%; 95% CI 1.0-2.7) than in women (0.5%; 95% CI 0.1-1.0; P = 0.005), whereas the prevalence of diastolic ALVD was comparable between genders (men: 35.8%; 95% CI = 32.7-38.9; women: 35.0%; 95% CI = 31.9-38.2). The NT-proBNP levels and severity of LVD increased with age. Overall, 1623 subjects (81.1% of the entire studied population) had preclinical HF (Stage A: 22.2% and stage B: 59.1% respectively). A large number of subjects in stage B of HF showed risk factor levels not at target.
  
  
  CONCLUSIONS
  In a population-based study, the prevalence of preclinical HF in the elderly is high. The prevalence of clinical HF is mainly due to HFpEF and is similar between genders.
authors.affiliation: Department of Cardiovascular Diseases, S. Giovanni-Addolorata Hospital, 00184 Rome, Italy. gfmureddu@tiscali.it
authors.forename: Gian Francesco
authors.initials: GF
authors.lastname: Mureddu
authors.forename: Nera
authors.initials: N
authors.lastname: Agabiti
authors.forename: Vittoria
authors.initials: V
authors.lastname: Rizzello
authors.forename: Francesco
authors.initials: F
authors.lastname: Forastiere
authors.forename: Roberto
authors.initials: R
authors.lastname: Latini
authors.forename: Giulia
authors.initials: G
authors.lastname: Cesaroni
authors.forename: Serge
authors.initials: S
authors.lastname: Masson
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cacciatore
authors.forename: Furio
authors.initials: F
authors.lastname: Colivicchi
authors.forename: Massimo
authors.initials: M
authors.lastname: Uguccioni
authors.forename: Carlo Alberto
authors.initials: CA
authors.lastname: Perucci
authors.forename: Alessandro
authors.initials: A
authors.lastname: Boccanelli
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D016017:Odds Ratio; D010446:Peptide Fragments / Q000097:blood; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D013318:Stroke Volume; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D016277:Ventricular Function, Left
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain