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European Journal of Heart Failure 2008 10(10):1040-1047; doi:10.1016/j.ejheart.2008.07.003
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© 2008 European Society of Cardiology

Global perceived health and ten-year cardiovascular mortality in elderly primary care patients with possible heart failure

Peter Johanssona,b,*, Anders Broströmb,c, Ulf Dahlströma,b and Urban Alehagena,b

a Department of Cardiology, Linköping University Hospital S-58185 Linköping, Sweden
b Department of Medicine and Care, Faculty of Health Sciences Linköping University S-58185 Linköping, Sweden
c Division of Clinical Neurophysiology, Linköping University Hospital S-58185 Linköping, Sweden

* Corresponding author. Department of Cardiology, University Hospital, S-581 85 Linköping, Sweden. Tel.: +46 13 222223; fax: +46 13 222224. E-mail address: peter.johansson{at}aries.vokby.se (P. Johansson).


  Abstract

Introduction: Although multi-item health-related quality of life (HRQoL) instruments provide prognostic information, they are rarely used in routine clinical practice.

Aim: To examine whether a single question about global perceived health (GPH) was a prognostic indicator of cardiovascular (CV) mortality over 10 years of follow-up in elderly patients with possible heart failure (HF) in primary care.

Method: GPH was measured using the first question on the Short-Form-36 concerning current health status. Of the 510 patients who underwent baseline evaluation, 448 patients were included.

Results: Cox proportional regression hazard analysis controlled for age, sex, NYHA class, diabetes, ischaemic heart disease, left ventricular ejection fraction and B-type natriuretic peptide plasma concentrations, showed that patients with GPH rated as "poor" or "good" were at four (HR 4.1 CI 95% 1.8–9.4) and three times (HR 3.4 CI 95% 1.4–7.8) the risk of CV mortality, respectively.

Conclusion: GPH is an independent predictor of CV mortality in elderly patients with possible HF. As a complement to clinical factors when evaluating severity of HF, GPH could be an important tool for identifying patients at risk of adverse CV events and in need of improved treatment.

Key Words: Health status indicator • Mortality • Aging • Chronic heart failure

Received January 22, 2008; Revised May 24, 2008; Accepted July 1, 2008


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