Outpatient management of heart failure in the United States, 2006-2008.

Published online

Journal Article

Better outpatient management of heart failure might improve outcomes and reduce the number of rehospitalizations. This study describes recent outpatient heart-failure management in the United States. We analyzed data from the National Ambulatory Medical Care Survey of 2006-2008, a multistage random sampling of non-Federal physician offices and hospital outpatient departments. Annually, 1.7% of all outpatient visits were for heart failure (51% females and 77% non-Hispanic whites; mean age, 73 ± 0.5 yr). Typical comorbidities were hypertension (62%), hyperlipidemia (36%), diabetes mellitus (35%), and ischemic heart disease (29%). Body weight and blood pressure were recorded in about 80% of visits, and health education was given in about 40%. The percentage of patients taking β-blockers was 38%; the percentage taking angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARBs) was 32%. Medication usage did not differ significantly by race or sex. In multivariate-adjusted logistic regression models, a visit to a cardiologist, hypertension, heart failure as a primary reason for the visit, and a visit duration longer than 15 minutes were positively associated with ACEI/ARB use; and a visit to a cardiologist, heart failure as a primary reason for the visit, the presence of ischemic heart disease, and visit duration longer than 15 minutes were positively associated with β-blocker use. Chronic obstructive pulmonary disease was negatively associated with β-blocker use. Approximately 1% of heart-failure visits resulted in hospitalization. In outpatient heart-failure management, gaps that might warrant attention include suboptimal health education and low usage rates of medications, specifically ACEI/ARBs and β-blockers.

Full Text

Duke Authors

Cited Authors

  • Mosalpuria, K; Agarwal, SK; Yaemsiri, S; Pierre-Louis, B; Saba, S; Alvarez, R; Russell, SD

Published Date

  • June 2014

Published In

Volume / Issue

  • 41 / 3

Start / End Page

  • 253 - 261

PubMed ID

  • 24955039

Pubmed Central ID

  • 24955039

Electronic International Standard Serial Number (EISSN)

  • 1526-6702

Digital Object Identifier (DOI)

  • 10.14503/THIJ-12-2947

Language

  • eng

Conference Location

  • United States