{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T13:55:26Z","timestamp":1773842126448,"version":"3.50.1"},"reference-count":37,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T00:00:00Z","timestamp":1630972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The prevalence of chronic heart failure (CHF) in patients assisted in primary care is not well known. We investigated the prevalence of CHF, its associated factors, and its therapeutic management. Methods and findings: This was a cross-sectional, multicenter study conducted in primary care (PC) in baseline patients of the IBERICAN study (Identification of the Spanish Population at Cardiovascular and Renal Risk). CHF was defined as the presence of this condition in the medical history, classifying patients according to the type of ventricular dysfunction in CHF with preserved ejection fraction (pEF), or CHF with reduced ejection fraction (rEF). Clinical characteristics, relationship between CHF and main cardiovascular risk factors (CVRF), and drug treatments used according to ejection fraction (EF) were analyzed. Results: A total of 8066 patients were included (54.5% women), average age (SD) was 57.9 (14.8) years, of which 3.1% (95% CI: 2.3\u20133.7) presented CHF, without differences between men and women. CHF with pEF (61.8%; 95% CI: 55.5\u201367.6) was more frequent in women, and CHF with rEF (38.1%; 95% CI: 33.2\u201345.5) (p = 0.028) was similar in both genders (65.9%; 95% CI: 57.1\u201373.4 vs. 57.3%; 95% CI: 47.7\u201365.8) (p = 0.188). A progressive increase of the prevalence with age (15.2% in \u226580 years) and with the aggregation of CVRF was observed. The most prescribed treatments were beta-blockers (54.7%) followed by angiotensin converting enzyme inhibitors (42.8%) and angiotensin II receptor antagonists (41.3%), without differences between pEF and rEF. The variables that are most associated with the probability of suffering CHF were a personal history of left ventricular hypertrophy (OR: 5.968; p &lt; 0.001), of atrial fibrillation (OR: 3.494; p &lt; 0.001), and of peripheral vascular disease (OR: 2.029; p &lt; 0.001). Conclusions: Three in every 100 patients included in the IBERICAN study presented CHF, of which two thirds had pEF. The condition increased exponentially with age and aggregation of CVRF. We did not find any differences in drug treatment according to the type of ventricular dysfunction. The treatment of HF with rEF has much room for improvement.<\/jats:p>","DOI":"10.3390\/jcm10184036","type":"journal-article","created":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T10:24:25Z","timestamp":1631010265000},"page":"4036","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prevalence of Chronic Heart Failure, Associated Factors, and Therapeutic Management in Primary Care Patients in Spain, IBERICAN Study"],"prefix":"10.3390","volume":"10","author":[{"given":"Jose L.","family":"Llisterri-Caro","sequence":"first","affiliation":[{"name":"Spanish Society of Primary Care Physicians (SEMERGEN)\u2019s Foundation, 28009 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4486-2820","authenticated-orcid":false,"given":"Sergio","family":"Cinza-Sanjurjo","sequence":"additional","affiliation":[{"name":"Porto do Son Health Center, Health Area of Santiago de Compostela, 15970 Santiago de Compostela, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0552-2804","authenticated-orcid":false,"given":"Vicente","family":"Mart\u00edn-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Institute of Biomedicine (IBIOMED), University of Le\u00f3n, 24004 Le\u00f3n, Spain"},{"name":"Epidemiology and Public Health Networking Biomedical Research Center (CIBERESP), 24004 Le\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo C.","family":"Rodr\u00edguez-Roca","sequence":"additional","affiliation":[{"name":"La Puebla de Montalb\u00e1n Health Table Center, 45516 Toledo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael M.","family":"Mic\u00f3-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Fontanars dels Alforins Health Center, X\u00e0tiva\u2013Ontinyent Department of Health, 46635 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4884-2242","authenticated-orcid":false,"given":"Antonio","family":"Segura-Fragoso","sequence":"additional","affiliation":[{"name":"Medicine Department, University of Castilla-La Mancha, 13003 Toledo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonsoles","family":"Velilla-Zancada","sequence":"additional","affiliation":[{"name":"Joaquin Elizalde Health Center, 26004 Logro\u00f1o, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Polo-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Casar de C\u00e1ceres Health Center, 10190 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfonso","family":"Barquilla-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Trujillo Health Center, 10200 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Rodr\u00edguez Padial","sequence":"additional","affiliation":[{"name":"Servicio de Cardiolog\u00eda, Complejo Hospitalario de Toledo, 45071 Toledo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel A.","family":"Prieto-D\u00edaz","sequence":"additional","affiliation":[{"name":"Vallob\u00edn-La Florida Health Center, 33012 Oviedo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Investigators of the IBERICAN Study and of the Spanish Society of Primary Care Physicians (SEMERGEN)\u2019s Foundation","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1093\/eurheartj\/ehz010","article-title":"The year in cardiology 2018: Heart failure","volume":"40","author":"Cleland","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_2","first-page":"1041","article-title":"Study investigators. Prevalence of heart failure in the Spanish general population aged over 45 years. The PRICE Study","volume":"61","author":"Anguita","year":"2008","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_3","first-page":"611","article-title":"Heart failure in outpatients: Comorbidities and management by different specialists. The EPISERVE Study","volume":"1","author":"Bertomeu","year":"2008","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_4","first-page":"373","article-title":"Galician study of heart failure in primary care (GALICAP Study)","volume":"60","year":"2007","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_5","first-page":"337","article-title":"Clinical characteristics of patients diagnosed of chronic heart failure attended in primary care. The CARDIOPRES study","volume":"207","year":"2007","journal-title":"Rev. Clin. Esp."},{"key":"ref_6","first-page":"1159","article-title":"The research group of the BADAPIC Registry. Clinical characteristics, treatment and short-term morbidity and mortality of patients with heart failure followed in heart failure clinics. Results of the BADAPIC Registry","volume":"57","year":"2004","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the heart failure association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1001\/jama.1995.03520420066040","article-title":"Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure","volume":"273","author":"Garg","year":"1995","journal-title":"JAMA"},{"key":"ref_9","first-page":"i1855","article-title":"On behalf of the Beta-blockers in heart failure collaborative group. effect of age and sex on efficacy and tolerability of \u03b2 blockers in patients with heart failure with reduced ejection fraction: Individual patient data meta-analysis","volume":"353","author":"Lip","year":"2016","journal-title":"BMJ"},{"key":"ref_10","first-page":"134","article-title":"Heart failure: A view from primary care","volume":"42","author":"Barrio","year":"2010","journal-title":"Aten. Primaria"},{"key":"ref_11","first-page":"e1","article-title":"Avoidable hospital admissions for heart failure, Spain","volume":"90","author":"Lorusso","year":"2016","journal-title":"Rev. Esp. Salud P\u00fablica"},{"key":"ref_12","first-page":"4","article-title":"Description of the sample, design and methods of the study for the identification of the Spanish population at cardiovascular and renal risk (IBERICAN)","volume":"46","year":"2020","journal-title":"Semergen"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1093\/eurheartj\/eht151","article-title":"ESH\/ESC Guidelines for the management of arterial hypertension the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)","volume":"34","author":"Mancia","year":"2013","journal-title":"Eur. Heart J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1093\/eurheartj\/ehy339","article-title":"ESC Scientific Document Group 2018. 2018 ESC\/ESH guidelines for the management of arterial hypertension","volume":"39","author":"Williams","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_15","unstructured":"Altman, D.G., Machin, D., Bryant, T.N., and Gardner, M.J. (2000). Statistics with Confidence, BMJ Books. [2nd ed.]."},{"key":"ref_16","first-page":"334","article-title":"Hypertension and heart failure in primary care and cardiology consultations of in Spain","volume":"203","year":"2003","journal-title":"Rev. Clin. Esp."},{"key":"ref_17","first-page":"213","article-title":"Heart failure in primary care: Attitudes, knowledge and self-care","volume":"50","year":"2018","journal-title":"Aten. Primaria"},{"key":"ref_18","first-page":"394","article-title":"Clinical profile and management patterns in outpatients with heart failure in Spain: INCA study","volume":"41","author":"Brotons","year":"2009","journal-title":"Aten. Primaria"},{"key":"ref_19","first-page":"166","article-title":"Use of the European heart failure self-care behaviour scale (EHFScBS) in a heart failure unit in Spain","volume":"59","author":"Urrutia","year":"2006","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1016\/S0002-9149(01)01568-5","article-title":"Prevalence of heart failure in Asturias (A region in the north of Spain)","volume":"87","author":"Cortina","year":"2001","journal-title":"Am. J. Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1002\/ejhf.549","article-title":"Medical resource use and expenditure in patients with chronic heart failure: A population-based analysis of 88,195 patients","volume":"18","author":"Vela","year":"2016","journal-title":"Eur. J. Heart Fail"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1093\/fampra\/cmq084","article-title":"Heart failure in the family practice: A study of the prevalence and co-morbidity","volume":"28","author":"Carmona","year":"2011","journal-title":"Fam. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/S0828-282X(10)70438-4","article-title":"Administrative data have high variation in validity for recording heart failure","volume":"26","author":"Quach","year":"2010","journal-title":"Can. J. Cardiol."},{"key":"ref_24","first-page":"1","article-title":"Heart failure in primary care: Prevalence related to age and comorbidity","volume":"20","author":"Grauw","year":"2019","journal-title":"Prim. Health Care Res. Dev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/S1388-9842(02)00034-X","article-title":"EPICA investigators.prevalence of chronic heart failure in southwestern Europe: The EPICA study","volume":"4","author":"Ceia","year":"2002","journal-title":"Eur. J. Heart Fail."},{"key":"ref_26","first-page":"649","article-title":"Epidemiology of heart failure in Spain over the last 20 years","volume":"66","year":"2013","journal-title":"Rev. Esp. Cardiol. (Engl. Ed.)"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Tiller, D., Russ, M., Greiser, K.H., Nuding, S., Ebelt, H., Kluttig, A., Kors, J.A., Thiery, J., Bruegel, M., and Haerting, J. (2013). Prevalence of symptomatic heart failure with reduced and with normal ejection fraction in an elderly general population\u2014The Carla study. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0059225"},{"key":"ref_28","first-page":"61","article-title":"Heart failure patients in primary care: Aging, comorbidities and polypharmacy","volume":"43","author":"Galindo","year":"2011","journal-title":"Aten. Primaria"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1056\/NEJM197112232852601","article-title":"The natural history of congestive heart failure: The Framingham study","volume":"285","author":"McKee","year":"1971","journal-title":"N. Engl. J. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1016\/j.recesp.2011.04.018","article-title":"Blood pressure control in hypertensive women aged 65 years or older in a primary care setting. MERICAP study","volume":"64","author":"Llisterri","year":"2011","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_31","first-page":"1","article-title":"Renal dysfunction and cardiac failure. An association that remains to be described","volume":"28","year":"2007","journal-title":"Dial. Traspl."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.amjcard.2011.03.057","article-title":"Effect of peripheral arterial disease on functional and clinical outcomes in patients with heart failure (from H-ACTION)","volume":"108","author":"Jones","year":"2011","journal-title":"Am. J. Cardiol."},{"key":"ref_33","first-page":"211","article-title":"Prescription in patients with chronic heart failure and multimorbidity attended in primary care","volume":"21","author":"Hermosilla","year":"2013","journal-title":"Qual. Prim. Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/j.recesp.2014.03.014","article-title":"Investigators of the VIDA\u2013IC study. Current situation of management of systolic heart failure in Spain: VIDA-IC study results","volume":"67","author":"Anguita","year":"2014","journal-title":"Rev. Esp. Cardiol. (Engl. Ed.)"},{"key":"ref_35","first-page":"785","article-title":"Adherence to the ESC heart failure treatment guidelines in Spain: ESC heart failure long-term registry","volume":"68","year":"2015","journal-title":"Rev. Esp. Cardiol. (Engl. Ed.)"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Farr\u00e9, N., Vela, E., Cl\u00e8ries, M., Bustins, M., Cainzos-Achirica, M., Enjuanes, C., Moliner, P., Ruiz, S., Verd\u00fa-Rotellar, J.M., and Com\u00edn-Colet, J. (2017). Real world heart failure epidemiology and outcome: A population-based analysis of 88, 195 patients. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0172745"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1056\/NEJMoa1409077","article-title":"PARADIGM-HF investigators and committees. Angiotensin-neprilysin inhibition versus enalapril in heart failure","volume":"371","author":"McMurray","year":"2014","journal-title":"N. Engl. J. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/18\/4036\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:57:51Z","timestamp":1760165871000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/18\/4036"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,7]]},"references-count":37,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["jcm10184036"],"URL":"https:\/\/doi.org\/10.3390\/jcm10184036","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,7]]}}}