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Hjartabilun meðal eldri Íslendinga. Algengi, nýgengi, undirliggjandi sjúkdómar og langtímalifun

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Authors
Haukur Einarsson
Guðmundur Þorgeirsson
Ragnar Danielsen
Örn Ólafsson
Thor Aspelund
Vilmundur Guðnason
Issue Date
2017-10-05

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Other Titles
Heart failure among elderly Icelanders: Incidence, prevalence, underlying diseases and long-term survival
Citation
Læknablaðið 2017,103(10):429-436
Abstract
Inngangur: Hjartabilun er bæði algengur og alvarlegur sjúkdómur sem leggst fyrst og fremst á eldra fólk. Skipta má hjartabilun í tvær megingerðir, hjartabilun með minnkað útstreymisbrot (HFrEF) og hjartabilun með varðveitt útstreymisbrot (HFpEF). Markmið þessarar rannsóknar var að kanna algengi, nýgengi, undirliggjandi sjúkdóma og lífshorfur beggja gerða hjartabilunar meðal eldri Íslendinga. Efniviðurog aðferðir: Rannsóknarhópurinn samanstóð af 5706 þátttakendum Öldrunarrannsóknar Hjartaverndar. Sjúkdómsgreiningar byggðust á gögnum úr sjúkraskrám Landspítala og voru sannreyndar á grundvelli fyrirfram ákveðinna skilmerkja Öldrunarrannsóknarinnar. Upplýsingar um undirliggjandi sjúkdóma og útstreymisbrot voru einnig fengnar úr sjúkraskrám Landspítala. Nýgengi var reiknað út frá sjúkdómsgreiningum þeirra þátttakenda sem greindust með hjartabilun eftir að þátttaka þeirra í Öldrunarrannsókninni hófst og fram til 28.2.2010. Algengi hjartabilunar var hins vegar reiknað út frá þátttakendum sem greinst höfðu með hjartabilun fyrir upphaf Öldrunarrannsóknar. Langtímalifun hjartabilunarsjúklinga er lýst með aðferð Kaplan-Meier. Niðurstöður: Algengi hjartabilunar mældist 3,6% miðað við árið 2004 og var það marktækt hærra hjá körlum en konum (p<0,001). Nýgengið mældist 16,2 tilvik á 1000 mannár og var það marktækt hærra hjá körlum en konum (p<0,001). Nýgengi HFrEF mælidst 6,1 tilvik á 1000 mannár og reyndist það einnig marktækt hærra hjá körlum en konum (p<0,001). Nýgengi HFpEF mældist 6,8 tilvik á 1000 mannár, en ekki var marktækur kynjamunur (p=0,62). Fimm ára lifun hjartabilunarsjúklinga reyndist vera 32,5% en ekki var tölfræðilega marktækur munur á hlutfallslegri lifun kynjanna (p=0,46). Þá var ekki tölfræðilega marktækur munur á lifun einstaklinga með HFpEF og HFrEF (p=0,52). Umræða: Algengi og nýgengi hjartabilunar er hátt meðal aldraðra á Íslandi og eykst í takt við hækkandi aldur. Karlar fá frekar hjartabilun en konur og að auki greinast þeir frekar með HFrEF en konur greinast frekar með HFpEF. Hjartabilun er alvarlegt sjúkdómsástand sem hefur mikil áhrif á lífshorfur.
Introduction: Heart failure (HF) is a common and a serious condition that predominantly affects elderly people. On the basis of the left ventricular ejection fraction (EF) it can be divided into HF with reduced or preserved ejection fraction (HFrEF and HFpEF, respectively). The goal of this study was to investigate the prevalence and incidence of HF among elderly Icelanders, explore underlying diseases and estimate the effect of HF on overall survival. Material and methods: Included were 5706 participants of the AGES study. The hospital records of those diagnosed with HF before entry into AGES were used to calculate prevalence and the records of those diagnosed from entry into AGES until 28.2.2010 were used to calculate incidence. All cases of HF were verified according to predetermined criteria for diagnosis. Information on underlying diseases and EF of HF patients were obtained from hospital records. Survival was estimated using Kaplan-Meier survival curves. Results: Lifetime prevalence of HF was 3.6% as of 2004, higher among men than women (p<0,001). The incidence was 16.2 cases per 1000 person-years, higher among men than among women (p<0,001). The incidence of HFrEF was 6.1 per 1000 person-years also higher among men than women (p<0,001). The incidence of HFpEF was 6.8 per 1000 person-years and there was no statistical difference between the sexes (p=0.62). The age adjusted 5-year survival rate of HF-patients was 32.5%, there was no statistical difference in relative survival between men and women (p=0.46). There was no statistical difference between the survival of patients with HFrEF and those with HFpEF (p=0.52). Conclusion: Both prevalence and incidence of HF are high among elderly Icelanders, increasing sharply with age and 5-year survival rate is only around 30%. While men are more likely to develop HF, especially HFrEF, women are more likely to be diagnosed with HFpEF.
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http://www.laeknabladid.is/tolublod/2017/10/nr/6522
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ae974a485f413a2113503eed53cd6c53
10.17992/lbl.2017.10.155
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Icelandic Journal Articles (Peer Reviewed)

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