Researchers find increase in comorbidities among hospitalized patients with heart failure

A study recently published in the journal Circulation looks at temporal trends in the burden of comorbidities and associated risk of mortality among patients with heart failure (HF) with preserved ejection fraction (HFpEF), in which the left ventricle of the heart is not able to relax enough to fill properly with blood, and HF with reduced ejection fraction (HFrEF), in which the left ventricle is not able contract enough to pump out as much blood.

“The medical complexity of patients hospitalized with HFpEF and HFrEF appears to be increasing over time,” said Melissa Caughey, Ph.D., an epidemiologist and instructor in the UNC/NC State Joint Department of Biomedical Engineering, and senior author of the study. “We used data from the surveillance component of the Atherosclerosis Risk in Communities (ARIC) study to examine HF-related hospitalizations from four U.S. areas from 2005 to 2014.”

Just over 5,400 hospitalizations were analyzed, with stratification by heart failure type and sex. Caughey says the following comorbidities were extracted from medical records: coronary artery disease, peripheral artery disease, hypertension, pulmonary hypertension, atrial fibrillation, stroke/transient ischemic attack (TIA), valvular heart disease, myocardial infarction, body mass index, diabetes mellitus, serum creatinine, chronic obstructive pulmonary disease (COPD), sleep apnea, depression, anemia, and thyroid disease. Researchers found that over time, the average number of comorbidities increased in both men and women with both heart failure types. However, HFpEF, which is more common in women and is now the predominant form of heart failure, had the worst comorbidity burden.

Of the comorbidities studied, Caughey says there was a decrease in the prevalence of coronary artery disease and an increase in nonatherosclerotic or non-cardiovascular comorbidities.

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