Prevalence of Chronic Heart Failure in a General Practice Study Performed in the Autonomous Province of Bolzano, Italy Giuliano Piccoliori
Background: Estimates of chronic heart failure prevalence provided by population-based studies differ from those derived from administrative and general practice databases. Chronic heart failure prevalence in the general practice population of the Autonomous Province of Bolzano is unknown.
Methods: In a general practice study, practitioners documented all patients diagnosed with chronic heart failure. A random sample of these cases was referred to hospital-based specialists for diagnostic validation. Descriptive statistics were used to present the data.
Results: Thirty nine general practitioners participated. Out of 67,256 subjects cared by the general practitioners, 693 patients were diagnosed, during a consecutive 12 week period, with chronic heart failure representing 1.03% (males 47%, average age 75.1 years, age range 30-95; females 53%, average age 79.6 years, age range 43-97). Prevalence were 1.1% (CI 95%, 0.9-1.3) in patients aged >18 years (N=61,758), 2.2% (2.0-2.4) in the >45 years of age group (N=32,614) and 4.7% (4.3-5.0) in the >65 years of age group (N=13,821). At the time of inclusion, 76% had undergone at least one echocardiography, 82.4% thoracic x-ray, and 93.9% electrocardiogramm tests; the original reports for these investigations were available in 81.1%, 87.9% and 88.2% of cases, respectively. The majority these patients were in early, low-severity stages of the disease. Validation by specialists of a random sample of 292 of these patients failed to confirm diagnosis in 38 cases (13%).
Conclusion: The crude point prevalence rates of chronic heart failure in our general practice population matches those reported for other Italian regions. In the >65 years of age group, prevalence rates are lower than those reported for other European regions. Since rural communities are prevalent in the Province of Bolzano, data suggest that living in a rural setting may be associated with changes in heart failure prevalence. Specialist involvement in heart failure care is recommended.