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Published in: Journal of Public Health 5/2021

01-10-2021 | Heart Failure | Original Article

Multimorbidity and multiple causes of death in heart failure

Authors: Tilahun Nigatu Haregu, Shane Nanayakkara, Melinda Carrington, David Kaye

Published in: Journal of Public Health | Issue 5/2021

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Abstract

Introduction

Patients with heart failure (HF) usually have multiple comorbid conditions that interact with HF, either leading to its development, aggravating its progression or reducing the effectiveness of treatment. Although the prevalence of HF comorbidities has been studied, more evidence is needed on the strength of their independent association with HF and HF mortality.

Objective

To examine the strength of association between HF and associated medical conditions.

Methods

We analysed data from the Baker Biobank, encompassing 6530 adults aged between 18 and 69 years, collected between January 2000 and December 2011. Mortality was determined through linkage to the National Death Index. Medical conditions were self-reported by patients at enrolment to the Biobank. The strength of association between HF and co-occurring medical conditions as a cause of illness and death was assessed using multivariate logistic regression. Hazards of mortality were determined using Cox regression models.

Results

Most HF patients (92.2%) had at least one additional medical condition. The most common comorbidities were hypertension, arrhythmia and dyslipidaemia. Coronary artery disease was the most common cause of death co-occurring with HF. HF patients had significantly higher odds of arrhythmia [odds ratio (OR) = 3.3; 95% confidence interval (CI): 2.7, 3.9). Patients with kidney disease had 3 (95% CI: 2.1, 4.4) times higher odds of co-occurring HF as a cause of death compared to those without kidney disease. Patients with a history of HF had 3.6 (95% CI: 2.45, 5.24) times higher hazard of mortality from kidney disease.

Conclusion

In multimorbidity analysis, other cardiovascular diseases had a strong association with HF. However, in multiple causes of death analysis, there was a strong association between kidney disease and HF.
Literature
go back to reference Haregu TN, Nanayakkara S, Kingwell B, Jennings G, Dart A, Carrington M et al (2019) The Baker Biobank: understanding cardiovascular outcomes. Heart Lung Circ (in press) Haregu TN, Nanayakkara S, Kingwell B, Jennings G, Dart A, Carrington M et al (2019) The Baker Biobank: understanding cardiovascular outcomes. Heart Lung Circ (in press)
go back to reference Silverberg D, Wexler D, Blum M, Schwartz D, Iaina A (2004) The association between congestive heart failure and chronic renal disease. Curr Opin Nephrol Hypertens 13(2):163–170CrossRef Silverberg D, Wexler D, Blum M, Schwartz D, Iaina A (2004) The association between congestive heart failure and chronic renal disease. Curr Opin Nephrol Hypertens 13(2):163–170CrossRef
go back to reference Tsutsui H, Tsuchihashi-Makaya M, Kinugawa S, Goto D, Takeshita A; JCARE-GENERAL Investigators (2007) Characteristics and outcomes of patients with heart failure in general practices and hospitals. Circ J 71(4):449–454CrossRef Tsutsui H, Tsuchihashi-Makaya M, Kinugawa S, Goto D, Takeshita A; JCARE-GENERAL Investigators (2007) Characteristics and outcomes of patients with heart failure in general practices and hospitals. Circ J 71(4):449–454CrossRef
Metadata
Title
Multimorbidity and multiple causes of death in heart failure
Authors
Tilahun Nigatu Haregu
Shane Nanayakkara
Melinda Carrington
David Kaye
Publication date
01-10-2021
Publisher
Springer Berlin Heidelberg
Published in
Journal of Public Health / Issue 5/2021
Print ISSN: 2198-1833
Electronic ISSN: 1613-2238
DOI
https://doi.org/10.1007/s10389-020-01223-0

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