Diagnosis and treatment of heart failure in primary health care among elderly patients with non-insulin-dependent diabetes mellitus, with special reference to use of echocardiography

Document type: Journal Articles
Article type: Original article
Peer reviewed: Yes
Author(s): Anders Halling, Johan Berglund
Title: Diagnosis and treatment of heart failure in primary health care among elderly patients with non-insulin-dependent diabetes mellitus, with special reference to use of echocardiography
Journal: SCANDINAVIAN JOURNAL OF PRIMARY HEALTH CARE
Year: 2003
Volume: 21
Issue: 2
Pagination: 96-98
ISSN: 0281-3432
Publisher: TAYLOR & FRANCIS AS
City: OSLO
URI/DOI: 10.1080/02813430310001699
ISI number: 000182821300008
Organization: Blekinge Institute of Technology
Department: School of Health Science (Sektionen för hälsa)
School of Health Science S-371 79 Karlskrona
+46 455 38 50 00
http://www.bth.se/hal/
Language: English
Abstract: Objective-The aim of the present study was to describe how the diagnosis of heart failure (HF) was assessed, aetiology and management in elderly patients with non-insulin-dependent diabetes mellitus (NIDDM) in primary health care, with special reference to use of echocardiography. Design-Descriptive retrospective investigation. Setting-Ronneby and Karlskrona communities, both situated on the Swedish south-east coast, 28,600 and 60,600 inhabitants, respectively. Patients-279 patients with NIDDM, mean age 77 years (range 70-85). Main outcome measures-Prevalence, aetiology, diagnostic procedures and management of HF. Results-The majority of patients were given the diagnosis of HF mainly as a result of clinical examination, ECG and chest X-ray, or of hospitalisation for HF. The diagnosis of HF by the primary care physicians was based on an objective evaluation of cardiac function in 8% of the patients. Hypertension was the predominant associated disease, followed by ischaemic heart disease (IHD). Therapy included diuretics (91%), angiotensin-converting enzyme (ACE) inhibitors (43%) and digoxin (53%). Conclusion-There is still a gap between current management of HF in primary care and guidelines, particularly in the case of diagnosis that is not generally based on an objective evaluation of cardiac function.
Subject: Nursing & Caring Sciences\General
Medical Sciences
Keywords: heart failure, diabetes mellitus, echocardiography, treatment, primary health care
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