Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2015

Open Access 01-12-2015 | Research article

Malnutrition and associated factors among heart failure patients on follow up at Jimma university specialized hospital, Ethiopia

Authors: Hiwot Amare, Leja Hamza, Henok Asefa

Published in: BMC Cardiovascular Disorders | Issue 1/2015

Login to get access

Abstract

Background

Malnutrition and cachexia are serious consequences of numerous chronic diseases. Severe heart failure patients could be related with marked weight loss. Malnutrition is associated with poor prognosis among heart failure patients. Despite its implication, factors associated with malnutrition among heart failure patients in Africa and Ethiopia was not addressed. Hence, in this study we tried to determine factors associated with malnutrition among heart failure patients on follow up at Jimma University specialized hospital, Ethiopia.

Methods

A cross-sectional study was done on 284 randomly selected heart failure patients. The nutritional status of the patients was assessed based on their serum albumin level (normal value 4–5 mg/dl) and triceps skin fold thickness. The data was analyzed using SPSS version 20.0. Multivariable logistic regression was used to identify factors associated with malnutrition among heart failure patients using SPSS 20.0.

Results

Based on serum albumin and triceps skin fold thickness, 77.8 % of patients were malnourished. Mean age of the patients was 48.3 ± 15.9 years. The commonest cause of heart failure was ischemic heart disease (34.9 %). Hypertension (36 %) was the commonest co morbid disease. Forty four percent of patients had New York heart association functional class II heart failure. Serum hemoglobin (AOR = 0.77, 95 % CI: 0.67–0.92) was found to be significantly associated with nutritional status of heart failure patients. As serum hemoglobin increases by 1gm/dl, the risk of malnutrition decreased by 15 % (P value = 0.03).

Conclusions

The majority of patients were malnourished. A higher hemoglobin concentration was associated with reduced odds of being malnourished.
Literature
1.
go back to reference Mendis S. Global status report on non communicable diseases. In: Cardiovascular diseases. Fact sheet N°317th ed. Geneva: World Health organization; 2014. Mendis S. Global status report on non communicable diseases. In: Cardiovascular diseases. Fact sheet N°317th ed. Geneva: World Health organization; 2014.
2.
go back to reference Kengne AP, Dzudie A, Sobngwi E. Heart failure in sub-Saharan Africa: A literature review with emphasis on individuals with diabetes. Vasc Health Risk Manag. 2008;4(1):123–30.CrossRefPubMedPubMedCentral Kengne AP, Dzudie A, Sobngwi E. Heart failure in sub-Saharan Africa: A literature review with emphasis on individuals with diabetes. Vasc Health Risk Manag. 2008;4(1):123–30.CrossRefPubMedPubMedCentral
3.
go back to reference Stenvinkel P, Andersson P. Do ACE-inhibitors supress tumor necrosis factor-alpha production in chronic renal failure. J Intern Med. 1999;246:503–7.CrossRefPubMed Stenvinkel P, Andersson P. Do ACE-inhibitors supress tumor necrosis factor-alpha production in chronic renal failure. J Intern Med. 1999;246:503–7.CrossRefPubMed
4.
go back to reference Anker S. Cardiac cachexia in early literature: a review of research prior to Medline. Int J Cardiol. 2002;85(1):7–14.CrossRefPubMed Anker S. Cardiac cachexia in early literature: a review of research prior to Medline. Int J Cardiol. 2002;85(1):7–14.CrossRefPubMed
5.
go back to reference Anker SD, Negassa A. Prognostic importance of weight loss in chronic heart failure and the effect of treatment with angiotensin-converting-enzyme inhibitors: an observational study. Lancet. 2003;361:1077–83.CrossRefPubMed Anker SD, Negassa A. Prognostic importance of weight loss in chronic heart failure and the effect of treatment with angiotensin-converting-enzyme inhibitors: an observational study. Lancet. 2003;361:1077–83.CrossRefPubMed
6.
go back to reference Barondess JA. The pathogenesis of cardiac cachexia. Arch Intern Med. 1966;117(6):841.CrossRef Barondess JA. The pathogenesis of cardiac cachexia. Arch Intern Med. 1966;117(6):841.CrossRef
7.
go back to reference Freeman LM. The pathophysiology of cardiac cachexia : current opinion in supportive and palliative. Cahchexia Nutrition Hydration. 2009;3:276–81. Freeman LM. The pathophysiology of cardiac cachexia : current opinion in supportive and palliative. Cahchexia Nutrition Hydration. 2009;3:276–81.
9.
go back to reference Azhar GW, Wei JY. Nutrition and cardiac cachexia. Curr Opi Clin Nutr Metab Care. 2006;9:18–23.CrossRef Azhar GW, Wei JY. Nutrition and cardiac cachexia. Curr Opi Clin Nutr Metab Care. 2006;9:18–23.CrossRef
10.
go back to reference Strassburg S, Anker SD. Cachexia in cardiovascular illness. In: Cachexia and wasting: a modern approach. 2006. p. 349–61.CrossRef Strassburg S, Anker SD. Cachexia in cardiovascular illness. In: Cachexia and wasting: a modern approach. 2006. p. 349–61.CrossRef
11.
go back to reference Jacobsson A, Pihl-Lindgren E. Malnutrition in patients suffering from chronic heart failure; the nurse’s care. Eur J Heart Fail. 2001;3(4):449–56.CrossRefPubMed Jacobsson A, Pihl-Lindgren E. Malnutrition in patients suffering from chronic heart failure; the nurse’s care. Eur J Heart Fail. 2001;3(4):449–56.CrossRefPubMed
12.
go back to reference Anker S. Imbalance of catabolic and anabolic pathways in chronic heart failure. Implication for treatment of cardiac cahexia. Scand J Nutr. 2002;46(1):3–10.CrossRef Anker S. Imbalance of catabolic and anabolic pathways in chronic heart failure. Implication for treatment of cardiac cahexia. Scand J Nutr. 2002;46(1):3–10.CrossRef
13.
go back to reference Sardesai V. Introduction to clinical nutrition. 2nd ed. Switzerland: Marcel Dekker; 2003. Sardesai V. Introduction to clinical nutrition. 2nd ed. Switzerland: Marcel Dekker; 2003.
14.
go back to reference Rao. Clinical examinations in cardiology. India Pvt. Limited: Elsevier; 2009. Rao. Clinical examinations in cardiology. India Pvt. Limited: Elsevier; 2009.
15.
go back to reference Qureshi AR, Alvestrand A, Divino-Filho JC, Gutierrez A, Heimbürger O, Lindholm B, et al. Inflammation, malnutrition, and cardiac disease as predictors of mortality in hemodialysis patients. J Am Soc Nephrol. 2002;13:28–36. Qureshi AR, Alvestrand A, Divino-Filho JC, Gutierrez A, Heimbürger O, Lindholm B, et al. Inflammation, malnutrition, and cardiac disease as predictors of mortality in hemodialysis patients. J Am Soc Nephrol. 2002;13:28–36.
16.
go back to reference Gastelurrutia P, Lupón J, Domingo M. Usefulness of body mass index to characterize nutritional status of heart failure patients. Am J Cardiol. 2011;108(8):1166–70.CrossRefPubMed Gastelurrutia P, Lupón J, Domingo M. Usefulness of body mass index to characterize nutritional status of heart failure patients. Am J Cardiol. 2011;108(8):1166–70.CrossRefPubMed
18.
go back to reference Davos CH, Doehner W. Body mass and survival in patients with chronic heart failure without cachexia: the importance of obesity. J Card Fail. 2003;9(1):29–35.CrossRefPubMed Davos CH, Doehner W. Body mass and survival in patients with chronic heart failure without cachexia: the importance of obesity. J Card Fail. 2003;9(1):29–35.CrossRefPubMed
19.
go back to reference Zamboni M, Rossi A. Sarcopenia, cachexia and congestive heart failure in the elderly. Endocr Metab Immune Disord Drug Targets. 2013;13(1):58–67.CrossRefPubMed Zamboni M, Rossi A. Sarcopenia, cachexia and congestive heart failure in the elderly. Endocr Metab Immune Disord Drug Targets. 2013;13(1):58–67.CrossRefPubMed
20.
go back to reference Kalantar-Zadeh K. Albumin levels predict survival in patients with systolic heart failure. Am Heart J. 2008;155(5):883–9.CrossRefPubMed Kalantar-Zadeh K. Albumin levels predict survival in patients with systolic heart failure. Am Heart J. 2008;155(5):883–9.CrossRefPubMed
21.
go back to reference Hussein MF. Prognostic significance of serum albumin levels in patients with systolic heart failure. Iraqi Postgrad Med J. 2012;11(3):411–7. Hussein MF. Prognostic significance of serum albumin levels in patients with systolic heart failure. Iraqi Postgrad Med J. 2012;11(3):411–7.
22.
go back to reference Dunn SP, Bleske B, Dorsch M, Macaulay T. Nutrition and heart failure: impact of drug therapies and management strategies. Nutr Clin Pract. 2009;24(1):60–75.CrossRefPubMed Dunn SP, Bleske B, Dorsch M, Macaulay T. Nutrition and heart failure: impact of drug therapies and management strategies. Nutr Clin Pract. 2009;24(1):60–75.CrossRefPubMed
23.
go back to reference Viorel G, Floreaa B, Moon J. Wasting of the left ventricle in patients with cardiac cachexia: a cardiovascular magnetic resonance study. Int J Cardiol. 2004;97(1):15–20.CrossRef Viorel G, Floreaa B, Moon J. Wasting of the left ventricle in patients with cardiac cachexia: a cardiovascular magnetic resonance study. Int J Cardiol. 2004;97(1):15–20.CrossRef
24.
go back to reference Gaziano TGJ. A textbook of cardiovascular medicine, vol. 2. 9th ed. Philadelphia: Elsevier Saunders; 2009. Gaziano TGJ. A textbook of cardiovascular medicine, vol. 2. 9th ed. Philadelphia: Elsevier Saunders; 2009.
25.
go back to reference Longo DL, Kasper DL, Fauci AS, editors. Harrison’s principles of internal medicine. 18th ed. New York: The McGraw-Hill Companies; 2012. Longo DL, Kasper DL, Fauci AS, editors. Harrison’s principles of internal medicine. 18th ed. New York: The McGraw-Hill Companies; 2012.
26.
go back to reference Lagua RT, Claudio VS. Nutrition and diet therapy reference dictionary. New York: Chapman & Hall; 1996.CrossRef Lagua RT, Claudio VS. Nutrition and diet therapy reference dictionary. New York: Chapman & Hall; 1996.CrossRef
27.
go back to reference Lainscak M, Keber I, Anker SD. Body composition changes in patients with systolic heart failure treated with beta blockers: a pilot study. Int J Cardiol. 2006;106(3):319–22.CrossRefPubMed Lainscak M, Keber I, Anker SD. Body composition changes in patients with systolic heart failure treated with beta blockers: a pilot study. Int J Cardiol. 2006;106(3):319–22.CrossRefPubMed
28.
go back to reference Sliwa K, Mayosi BM. Recent advances in the epidemiology, pathogenesis and prognosis of acute heart failure and cardiomyopathy in Africa. Heart. 2013;99(18):1317–22.CrossRefPubMed Sliwa K, Mayosi BM. Recent advances in the epidemiology, pathogenesis and prognosis of acute heart failure and cardiomyopathy in Africa. Heart. 2013;99(18):1317–22.CrossRefPubMed
29.
go back to reference Sliwa K, Davison BA, Mayosi BM, Damasceno A, Sani M, Ogah OS, et al. Readmission and death after an acute heart failure event: predictors and outcomes in sub-Saharan Africa: results from the THESUS-HF registry. Eur Heart J. 2013;34(40):3151–9.CrossRefPubMed Sliwa K, Davison BA, Mayosi BM, Damasceno A, Sani M, Ogah OS, et al. Readmission and death after an acute heart failure event: predictors and outcomes in sub-Saharan Africa: results from the THESUS-HF registry. Eur Heart J. 2013;34(40):3151–9.CrossRefPubMed
30.
go back to reference Mitchell J. Treatment of heart failure in African Americans--a call to action. J Natl Med Assoc. 2011;103(2):86–98.CrossRefPubMed Mitchell J. Treatment of heart failure in African Americans--a call to action. J Natl Med Assoc. 2011;103(2):86–98.CrossRefPubMed
31.
go back to reference Teklu B, Parry E, Pavlica D. Ethiopian cardiovascular studies. X. Normal variations of the electrocardiogram in Ethiopians. Ethiop Med J. 1971;9:133–9.PubMed Teklu B, Parry E, Pavlica D. Ethiopian cardiovascular studies. X. Normal variations of the electrocardiogram in Ethiopians. Ethiop Med J. 1971;9:133–9.PubMed
32.
go back to reference Mbewu AD. Can developing country systems cope with the epidemics of cardiovascular disease? New Delhi: Heart Health Conference; 1998. Mbewu AD. Can developing country systems cope with the epidemics of cardiovascular disease? New Delhi: Heart Health Conference; 1998.
34.
go back to reference Nicol M. Identification of malnutrtion in heart failure patients. Eur J Cardiovasc Nurs. 2002;1:139–47.CrossRefPubMed Nicol M. Identification of malnutrtion in heart failure patients. Eur J Cardiovasc Nurs. 2002;1:139–47.CrossRefPubMed
35.
go back to reference Mancini DM, Walter G, Reichek N, Lenkinski R, McCully KK, Mullen JL, et al. Contribution of skeletal muscle atrophy to exercise intolerance and altered muscle metabolism in heart failure. Circulation. 1992;85(4):1364–73.CrossRefPubMed Mancini DM, Walter G, Reichek N, Lenkinski R, McCully KK, Mullen JL, et al. Contribution of skeletal muscle atrophy to exercise intolerance and altered muscle metabolism in heart failure. Circulation. 1992;85(4):1364–73.CrossRefPubMed
36.
go back to reference Anker SD, Ponikowski P, Varney S. Wasting as independent risk factor of survival in chronic heart failure. Lancet. 1997;349:1050–3.CrossRefPubMed Anker SD, Ponikowski P, Varney S. Wasting as independent risk factor of survival in chronic heart failure. Lancet. 1997;349:1050–3.CrossRefPubMed
37.
go back to reference WHO. Nutrition Landscape Information System (NLiS), Ethiopia. Geneva: World Health Organization; 2005. WHO. Nutrition Landscape Information System (NLiS), Ethiopia. Geneva: World Health Organization; 2005.
38.
go back to reference Central Statistical Agency. Mini Ethiopian demograhic health survey. Addis Ababa: Central Statistical Agency; 2014. Central Statistical Agency. Mini Ethiopian demograhic health survey. Addis Ababa: Central Statistical Agency; 2014.
39.
go back to reference Carr J. Prevalence and hemodynamic correlates of malnutrition in severe congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol. 1989;15(63(11)):709–13.CrossRef Carr J. Prevalence and hemodynamic correlates of malnutrition in severe congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol. 1989;15(63(11)):709–13.CrossRef
40.
go back to reference Elabbassi W. Prevalence and clinical implications of anemia in congestive heart failure patients followed at a specialized hospital. Congest Heart Fail. 2007;12(258–264):258. Elabbassi W. Prevalence and clinical implications of anemia in congestive heart failure patients followed at a specialized hospital. Congest Heart Fail. 2007;12(258–264):258.
Metadata
Title
Malnutrition and associated factors among heart failure patients on follow up at Jimma university specialized hospital, Ethiopia
Authors
Hiwot Amare
Leja Hamza
Henok Asefa
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2015
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-015-0111-4

Other articles of this Issue 1/2015

BMC Cardiovascular Disorders 1/2015 Go to the issue