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Patterns of Comorbidity in Older Adults with Heart Failure: The Cardiovascular Research Network PRESERVE Study

Authors

  • Jane S. Saczynski PhD,

    Corresponding author
    1. Division of UMass Medical School Geriatric Medicine, University of Massachusetts, Worcester, Massachusetts
    2. Department of Quantitative Health Sciences, University of Massachusetts, Worcester, Massachusetts
    • Meyers Primary Care Institute and Fallon Community Health Plan, Worcester, Massachusetts
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  • Alan S. Go MD,

    1. Division of Research, Kaiser Permanente of Northern California, Oakland, California
    2. Departments of Epidemiology, Biostatistics, and Medicine, University of California at San Francisco, San Francisco, California
    3. Department of Health Research and Policy, School of Medicine, Stanford University, Palo Alto, California
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  • David J. Magid MD,

    1. Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado
    2. Colorado Cardiovascular Outcomes Research Consortium, Denver, Colorado
    3. School of Medicine, University of Colorado Aurora, Aurora, Colorado
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  • David H. Smith PhD,

    1. Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
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  • David D. McManus MD,

    1. Meyers Primary Care Institute and Fallon Community Health Plan, Worcester, Massachusetts
    2. Department of Quantitative Health Sciences, University of Massachusetts, Worcester, Massachusetts
    3. Division of Cardiovascular Medicine, Medical School, University of Massachusetts, Worcester, Massachusetts
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  • Larry Allen MD,

    1. Division of Cardiology, University of Colorado, Denver, Colorado
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  • Jessica Ogarek MS,

    1. Meyers Primary Care Institute and Fallon Community Health Plan, Worcester, Massachusetts
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  • Robert J. Goldberg PhD,

    1. Meyers Primary Care Institute and Fallon Community Health Plan, Worcester, Massachusetts
    2. Department of Quantitative Health Sciences, University of Massachusetts, Worcester, Massachusetts
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  • Jerry H. Gurwitz MD

    1. Meyers Primary Care Institute and Fallon Community Health Plan, Worcester, Massachusetts
    2. Division of UMass Medical School Geriatric Medicine, University of Massachusetts, Worcester, Massachusetts
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Address correspondence to Jane S. Saczynski, Division of Geriatric Medicine and the Meyers Primary Care Institute University of Massachusetts Medical School, 377 Plantation St., Suite 315, Worcester, MA 01605. E-mail: Jane.saczynski@umassmed.edu

Abstract

Objectives

To examine whether the total burden of comorbidity and pattern of co-occurring conditions varies in individuals with heart failure (HF) with preserved left ventricular ejection fraction (LVEF) (HF-P) or HF with reduced LVEF (HF-R).

Design

Cross-sectional cohort study.

Setting

Four participating health plans within the National Heart, Lung, and Blood Institute–sponsored Cardiovascular Research Network.

Participants

All members aged 65 and older with HF based on hospital discharge and ambulatory visit diagnoses.

Measurements

Participants with a LVEF of 50% or greater were classified as having HF-P. Presence of cardiac and noncardiac comorbidities was obtained from health plan administrative databases.

Results

Of 23,435 individuals identified with HF and LVEF information, 53% (12,407) had confirmed HF-P (mean age 79.6; 60% female). More than three-quarters of the sample had three or more co-occurring conditions in addition to HF, and half had five or more cooccurring conditions. Participants with HF-P had a slightly higher burden of comorbidity than those with HF-R (mean 4.5 vs 4.4, = .002). Patterns of how specific conditions co-occurred did not vary in participants with preserved or reduced systolic function.

Conclusion

There is a high degree of comorbidity and multiple morbidity in individuals with HF. The burden and pattern of comorbidity varies only slightly in individuals with preserved or reduced LVEF.

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