Symptoms associated with an abnormal echocardiogram in elderly primary care hypertension patients.
BACKGROUND
The prevalence and diagnostic value of heart failure symptoms in elderly primary care patients with hypertension is unknown.


OBJECTIVE
To assess the prevalence, sensitivity, specificity, positive and negative predictive value of symptoms in association with an abnormal echocardiogram.


METHODS
Cross-sectional screening study in five general practices in the south-east of the Netherlands.


METHODS
Between June 2010 and January 2013, 591 primary care hypertension patients aged between 60 and 85 years were included, without known heart failure and not treated by a cardiologist. All patients underwent an echocardiogram and a structured interview including assessment of heart failure symptoms: shortness of breath, fatigue, oedema, cold extremities, and restless sleep.


CONCLUSIONS
Restless sleep was reported by 25 %, cold extremities by 23 %, fatigue by 19 %, shortness of breath by 17 %, and oedema by 13 %. Oedema was the only symptom significantly associated with an abnormal echocardiogram (positive predictive value was 45 %, sensitivity 20 %, and specificity 90 %, OR 2.12; 95 % CI = 1.23-3.64), apart from higher age (OR 1.06; 95 % CI = 1.03-1.09), previous myocardial infarction (OR 3.00; 95 % CI = 1.28-7.03), and a systolic blood pressure of >160 mmHg (OR 1.62; 95 % CI = 1.08-2.41). Screening with echocardiography might be considered in patients with oedema.
Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, PO Box: 90153, 5000 LE, Tilburg, the Netherlands.
L
L
Ringoir
J W
JW
Widdershoven
S S
SS
Pedersen
J M
JM
Keyzer
V J
VJ
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