Objective: To examine the epidemiology, primary care burden, and treatment of heart failure in Scotland, UK. Design: Cross sectional data from primary care practices participating in the Scottish continuous morbidity ...Objective: To examine the epidemiology, primary care burden, and treatment of heart failure in Scotland, UK. Design: Cross sectional data from primary care practices participating in the Scottish continuous morbidity recording scheme between 1 April 1999 and 31 March 2000. Setting: 53 primary care practices(307 741 patients). Subjects: 2186 adult patients with heart failure. Results: The prevalence of heart failure in Scotland was 7.1 in 1000, increasing with age to 90.1 in 1000 among patients ≥85 years. The incidence of heart failure was 2.0 in 1000, increasing with age to 22.4 in 1000 among patients ≥85 years. For older patients, consultation rates for heart failure equalled or exceeded those for angina and hypertension. Respiratory tract infection was the most common comorbidity leading to consultation. Among men, 23%were prescribed a βblocker, 11 %spironolactone, and 46%an angiotensin converting enzyme inhibitor. The corresponding figures for women were 20%(p=0.29 versus men), 7%(p=0.02), and 34%(p< 0.001). Among patients< 75 years 26%were prescribed a βblocker, 11%spironolactone, and 50%an angiotensin converting enzyme inhibitor. The corresponding figures for patients ≥75 years were 19%(p=0.04 versus patients< 75), 7%(p=0.04), and 33%(p < 0.001). Conclusions: Heart failure is a common condition, especially with advancing age. In the elderly, the community burden of heart failure is at least as great as that of angina or hypertension. The high rate of concomitant respiratory tract infection emphasises the need for strategies to immunise patients with heart failure against influenza and pneumococcal infection. Drugs proven to improve survival in heart failure are used less frequently for elderly patients and women.展开更多
Objective: To examine the epidemiology, primary care burden and treatment of angina in Scotland. Design: Cross-sectional data from primary care practices participating in the Scottish continuous morbidity recording sc...Objective: To examine the epidemiology, primary care burden and treatment of angina in Scotland. Design: Cross-sectional data from primary care practices participating in the Scottish continuous morbidity recording scheme between 1 April 2001 and 31 March 2002. Setting: 55 primary care practices(362 155 patients). Participants: 9508 patients with angina. Results: The prevalence of angina in Scotland was 28/1000 in men and 25/1000 in women(p< 0.05) and increased with age. The prevalence of angina also increased with increasing socioeconomic deprivation from 18/1000 in the least de-prived category to 31/1000 in the most deprived group(p< 0.001 for trend). The incidence of angina was higher in men(1.8/1000) than in women(1.4/1000)(p=0.004) and increased with increasing age and socioeconomic deprivation. Socioeconomically deprived patients(0.48 contacts/patient among the most deprived) were less likely than affluent patients(0.58 contacts/patient among the least deprived) to see their general practitioner on an ongoing basis (p=0.006 for trend). Among men, 52%were prescribed βblockers, 44%calcium channel blockers, 72%aspirin, 54%statins and 36%angiotensin converting enzyme inhibitors or angiotensin receptor blockers. The corresponding prescription rates for women were 46%(p< 0.001), 41%(p=0.02), 69%(p< 0.001), 45%(p< 0.001) and 30%(p< 0.001). Among patients< 75 years old 52%were prescribed a βblocker and 58%a statin. The corresponding figures for patients ≥75 years were 42%(p< 0.001) and 31%(p< 0.001). Conclusions: Angina is a common condition, more so in men than in women. Socioeconomically deprived patients are more likely to have angina but are less likely to consult their general practitioner. Guideline-recommended treatments for angina are underused in women and older patients. These suboptimal practice patterns, which are worst in older women, are of particular concern, as in Scotland more women(and particularly older women) than men have angina.展开更多
文摘Objective: To examine the epidemiology, primary care burden, and treatment of heart failure in Scotland, UK. Design: Cross sectional data from primary care practices participating in the Scottish continuous morbidity recording scheme between 1 April 1999 and 31 March 2000. Setting: 53 primary care practices(307 741 patients). Subjects: 2186 adult patients with heart failure. Results: The prevalence of heart failure in Scotland was 7.1 in 1000, increasing with age to 90.1 in 1000 among patients ≥85 years. The incidence of heart failure was 2.0 in 1000, increasing with age to 22.4 in 1000 among patients ≥85 years. For older patients, consultation rates for heart failure equalled or exceeded those for angina and hypertension. Respiratory tract infection was the most common comorbidity leading to consultation. Among men, 23%were prescribed a βblocker, 11 %spironolactone, and 46%an angiotensin converting enzyme inhibitor. The corresponding figures for women were 20%(p=0.29 versus men), 7%(p=0.02), and 34%(p< 0.001). Among patients< 75 years 26%were prescribed a βblocker, 11%spironolactone, and 50%an angiotensin converting enzyme inhibitor. The corresponding figures for patients ≥75 years were 19%(p=0.04 versus patients< 75), 7%(p=0.04), and 33%(p < 0.001). Conclusions: Heart failure is a common condition, especially with advancing age. In the elderly, the community burden of heart failure is at least as great as that of angina or hypertension. The high rate of concomitant respiratory tract infection emphasises the need for strategies to immunise patients with heart failure against influenza and pneumococcal infection. Drugs proven to improve survival in heart failure are used less frequently for elderly patients and women.
文摘Objective: To examine the epidemiology, primary care burden and treatment of angina in Scotland. Design: Cross-sectional data from primary care practices participating in the Scottish continuous morbidity recording scheme between 1 April 2001 and 31 March 2002. Setting: 55 primary care practices(362 155 patients). Participants: 9508 patients with angina. Results: The prevalence of angina in Scotland was 28/1000 in men and 25/1000 in women(p< 0.05) and increased with age. The prevalence of angina also increased with increasing socioeconomic deprivation from 18/1000 in the least de-prived category to 31/1000 in the most deprived group(p< 0.001 for trend). The incidence of angina was higher in men(1.8/1000) than in women(1.4/1000)(p=0.004) and increased with increasing age and socioeconomic deprivation. Socioeconomically deprived patients(0.48 contacts/patient among the most deprived) were less likely than affluent patients(0.58 contacts/patient among the least deprived) to see their general practitioner on an ongoing basis (p=0.006 for trend). Among men, 52%were prescribed βblockers, 44%calcium channel blockers, 72%aspirin, 54%statins and 36%angiotensin converting enzyme inhibitors or angiotensin receptor blockers. The corresponding prescription rates for women were 46%(p< 0.001), 41%(p=0.02), 69%(p< 0.001), 45%(p< 0.001) and 30%(p< 0.001). Among patients< 75 years old 52%were prescribed a βblocker and 58%a statin. The corresponding figures for patients ≥75 years were 42%(p< 0.001) and 31%(p< 0.001). Conclusions: Angina is a common condition, more so in men than in women. Socioeconomically deprived patients are more likely to have angina but are less likely to consult their general practitioner. Guideline-recommended treatments for angina are underused in women and older patients. These suboptimal practice patterns, which are worst in older women, are of particular concern, as in Scotland more women(and particularly older women) than men have angina.
