Campos Carlos, Magwire Melissa, Butler Javed, Hoovler Anthony, Sabharwal Anup, Shah Sanjiv J
Department of Family Medicine, UT Health San Antonio, San Antonio, TX, USA.
Saint Luke's Mid America Heart Institute, Kansas City, MO, USA.
BMC Prim Care. 2024 Aug 8;25(1):288. doi: 10.1186/s12875-024-02549-4.
Obesity (body mass index ≥ 30 kg/m) is a major risk factor for heart failure with preserved ejection fraction (HFpEF) and affects most patients with HFpEF. Patients living with obesity may experience delays in HFpEF diagnosis and management. We aimed to understand the clinical journey of patients with obesity and HFpEF and the role of primary care providers (PCPs) in diagnosing and managing patients with both conditions.
An anonymous, US population-based online survey was conducted in September 2020 among 114 patients with self-reported HFpEF and obesity and 200 healthcare providers, 61 of whom were PCPs who treat patients with HFpEF and obesity.
Half of patients (51%) with HFpEF reported waiting an average of 11 months to discuss their symptoms with a PCP; 11% then received their diagnosis from a PCP. PCPs initiated treatment and oversaw the management of HFpEF only 35% of the time, and 44% of PCPs discussed obesity treatment medication options with their patients. Only 20% of PCPs indicated they had received formal obesity management training, and 79% of PCPs indicated they would be interested in obesity management training and support.
PCPs could play a valuable role in addressing obesity and referring patients with obesity and signs and symptoms of HFpEF to cardiologists. Increased awareness of HFpEF and its link to obesity may help PCPs more quickly identify and diagnose their patients with these conditions.
肥胖(体重指数≥30kg/m²)是射血分数保留的心力衰竭(HFpEF)的主要危险因素,影响大多数HFpEF患者。肥胖患者在HFpEF的诊断和管理方面可能会出现延迟。我们旨在了解肥胖合并HFpEF患者的临床病程以及初级保健提供者(PCP)在诊断和管理这两种疾病患者中的作用。
2020年9月,在美国对114名自我报告患有HFpEF和肥胖症的患者以及200名医疗保健提供者进行了一项基于人群的匿名在线调查,其中61名PCP治疗HFpEF和肥胖症患者。
一半(51%)的HFpEF患者报告平均等待11个月才与PCP讨论他们的症状;其中11%随后从PCP处得到诊断。PCP仅在35%的时间启动治疗并监督HFpEF的管理,44%的PCP与患者讨论肥胖治疗药物选择。只有20%的PCP表示他们接受过正式的肥胖管理培训,79%的PCP表示他们有兴趣接受肥胖管理培训和支持。
PCP在解决肥胖问题以及将患有肥胖症和HFpEF体征及症状的患者转诊给心脏病专家方面可以发挥重要作用。提高对HFpEF及其与肥胖症关联的认识可能有助于PCP更快地识别和诊断患有这些疾病的患者。