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European Journal of Heart Failure 2007 9(6-7):709-715; doi:10.1016/j.ejheart.2007.02.004
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© 2007 European Society of Cardiology

Non-cardiovascular co-morbidity in elderly patients with heart failure outnumbers cardiovascular co-morbidity

Mark C. van der Wela,b,*, Rene W.M.M. Jansenb, J. Carel Bakxa, Hans H.J. Bora, Marcel G.M. OldeRikkertb and Chris van Weela

a Department of General Practice, Radboud University Nijmegen Medical Centre, The Netherlands
b Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands

* Corresponding author. Department of General Practice, Radboud University Medical Centre Nijmegen, Huispost 117 HAG, 6500 HB, Nijmegen, PO BOX 9101, The Netherlands. Tel: +31 243616326; fax: +31 243541862. E-mail address: m.vanderwel{at}hag.umcn.nl


  Abstract

Background: Patients with heart failure often suffer from multiple co-morbid conditions. However, until now only cardiovascular co-morbidity has been well described.

Aims: To understand heart failure in the context of multi-morbidity, by describing the age and sex specific patterns of non-cardiovascular co-morbidity in elderly patients with heart failure in general practice.

Methods: All patients aged 65 years and over, diagnosed with heart failure in four practices of the Nijmegen Academic Practice-based Research Network (NPBRN) between January 1999 and December 2003 were selected, and the prevalence of 27 cardio- and non-cardiovascular co-morbidities determined.

Results: Of the 269 patients identified (mean age 79 years; 57% women), 80.2% had four or more co-morbidities. With increasing age, a significant increase in the prevalence of non-cardiovascular conditions like visual and hearing impairments, osteoarthritis, dementia and urine incontinence; and a decrease in cardiovascular conditions like myocardial infarction and in women, hypertension, was observed. In patients aged 85 years and over, non-cardiovascular disorders predominated over cardiovascular disorders.

Conclusions: In elderly patients with heart failure, the prevalence of non-cardiovascular co-morbidity is very high and exceeds the prevalence of cardiovascular conditions. Diseases such as dementia and osteoarthritis must be taken into account in the management of elderly patients with heart failure.

Key Words: Heart failure • Elderly • Co-morbidity • Non-cardiovascular • General practice

Received April 18, 2006; Revised November 7, 2006; Accepted February 19, 2007


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