Departement of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium.
Louvain Drug Research Institute, Clinical Pharmacy Research Group and Institute of Health and Society (IRSS), Université catholique de Louvain (UCL), Brussels, Belgium.
BMJ Open. 2019 Jan 7;9(1):e022972. doi: 10.1136/bmjopen-2018-022972.
To assess the prevalence and incidence of heart failure (HF) stages A to C/D and their evolution over a 16-year period. Additionally, trends in comorbidities and cardiovascular (CV) treatment in patients with HF were studied in the same period.
Registry-based study.
Primary care, Flanders, Belgium.
Data were obtained from Intego, a morbidity registration network in which 111 general practitioners of 48 practices collaborate. In the study period between 2000 and 2015, data from 165 796 unique patients aged 45 years and older were available.
Prevalence and incidence were calculated for HF stage A, B and C/D by gender. Additionally, the trend in age-standardised prevalence and incidence rates between 2000 and 2015 was analysed with joint-point regression. The same model was used to study trends in comorbidity profiles in incident HF cases and trends in cardiovascular medication in prevalent HF cases.
We found a downward trend in the incidence and prevalence of HF stage C/D in Flemish general practice between 2000 and 2015, whereas the prevalence and incidence of stage A and B increased. The burden of comorbidities in incident HF cases increased during the study period, as shown by an increasing disease count (p<0.001). The prescription of cardiovascular medication such as renin-angiotensin-aldosterone system blockade, β-blockers and statins showed a sharp increase in the first part of the study period (2000-2008).
Age-standardised incidence and prevalence of HF stage C/D showed a slightly downward trend over the past 16 years, probably due to the sharp increase in cardiovascular treatment. However, the increasing age-standardised incidence and prevalence of stage A and B, as precursors of symptomatic HF, together with a rising comorbid burden, highlights the challenges we are still facing.
评估心力衰竭（HF）A 至 C/D 期的患病率和发病率及其在 16 年内的演变。此外，还研究了同一时期 HF 患者合并症和心血管（CV）治疗的趋势。
基于登记的研究。
初级保健，比利时佛兰德。
数据来自 Intego，这是一个发病率登记网络，其中 48 个实践中的 111 名全科医生合作。在 2000 年至 2015 年的研究期间，获得了 165796 名年龄在 45 岁及以上的独特患者的数据。
按性别计算 HF 阶段 A、B 和 C/D 的患病率和发病率。此外，使用联合点回归分析 2000 年至 2015 年之间年龄标准化患病率和发病率的趋势。使用相同的模型研究新发病例中合并症谱的趋势和现患 HF 病例中心血管药物的趋势。
我们发现，2000 年至 2015 年，佛兰德全科医生中 HF 阶段 C/D 的发病率和患病率呈下降趋势，而阶段 A 和 B 的患病率和发病率增加。在研究期间，新发病例中合并症的负担增加，表现为疾病数量增加（p<0.001）。心血管药物的处方，如肾素-血管紧张素-醛固酮系统阻滞剂、β受体阻滞剂和他汀类药物，在研究的前半段呈急剧增加（2000-2008 年）。
过去 16 年来，HF 阶段 C/D 的年龄标准化发病率和患病率呈略有下降趋势，可能是由于心血管治疗的急剧增加。然而，HF 症状前阶段 A 和 B 的发病率和患病率呈上升趋势，且合并症负担增加，这突出了我们仍然面临的挑战。
