Abstract P031: Multimorbidity in Heart Failure with Preserved and Reduced Ejection Fraction: A Community Study
Background: Multimorbidity is common in heart failure (HF), yet differences in co-morbid chronic conditions by type of HF (HF with preserved vs. reduced ejection fraction (EF)) are not well documented.
Methods: We determined the prevalence and distribution of 25 chronic conditions by preserved vs. reduced EF among patients with incident HF enrolled in a community study from 9/2003-6/2012. HF was validated by the Framingham criteria, and an EF ≥50% defined preserved EF. Chronic conditions were identified within the 5 years prior to HF by codes defined by Centers for Medicare & Medicaid Services. Logistic regression determined associations of each comorbidity with type of HF (preserved vs. reduced EF) after adjusting for age and sex.
Results: Among 668 incident HF patients (mean age 74±14, 51% male), the most common co-morbid conditions were hypertension, hyperlipidemia, and ischemic heart disease. Cataracts, rheumatoid arthritis/osteoarthritis, and anemia were also common, occurring in >1/3 of HF patients. On average, patients with preserved EF had 1 extra co-morbid condition compared to those with reduced EF (6 vs. 5, respectively). After adjusting for age and sex, comorbidities associated with HF with preserved EF include hypertension, hyperlipidemia, cataracts, rheumatoid arthritis/osteoarthritis, anemia, chronic kidney disease, chronic obstructive pulmonary disease, and depression, whereas a prior myocardial infarction was associated with presenting with reduced EF (figure). The remaining co-morbid conditions (including some not shown in the figure, such as breast, colorectal, lung, endometrial, and prostate cancer, and benign prostatic hyperplasia) were not associated with type of HF.
Conclusions: HF patients presenting with preserved EF have more co-morbid chronic conditions compared to those with reduced EF. This excess comorbidity burden is important to characterize and understand as it may explain differences in outcomes and healthcare utilization between HF patients with preserved and reduced EF.
Author Disclosures: A.M. Chamberlain: None. Y. Gerber: None. S.M. McNallan: None. S.M. Dunlay: None. S.A. Weston: None. V.L. Roger: None.
- © 2014 by American Heart Association, Inc.