{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T03:18:55Z","timestamp":1772507935207,"version":"3.50.1"},"reference-count":48,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,5,7]],"date-time":"2022-05-07T00:00:00Z","timestamp":1651881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"AstraZeneca"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Introduction: Heart failure (HF) is a clinical syndrome caused by structural and functional cardiac abnormalities resulting in the impairment of cardiac function, entailing significant mortality. The prevalence of HF has reached epidemic proportions in the last few decades, mainly in the elderly, but recent evidence suggests that its epidemiology may be changing. Objective: Our objective was to estimate the prevalence of HF and its subtypes, and to characterize HF in a population of integrated care users. Material and Methods: A non-interventional cross-sectional study was performed in a healthcare center that provides primary, secondary and tertiary health cares. Echocardiographic parameters (left ventricle ejection fraction (LVEF) and evidence of structural heart disease) and elevated levels of natriuretic peptides were used to define two HF phenotypes: (i) HF with a reduced ejection fraction (HFrEF, LVEF \u2264 40% and either NT-proBNP \u2265 400 pg\/mL (\u2265600 pg\/mL if atrial fibrillation (AF)\/flutter) or BNP \u2265 100 pg\/mL (\u2265125 pg\/mL if AF\/flutter)) and (ii) HF with a non-reduced ejection fraction (HFnrEF), which encompasses both HFpEF (LVEF \u2265 50% and either NT-proBNP \u2265 200 pg\/mL (\u2265600 pg\/mL if AF\/flutter) or BNP \u2265 100 pg\/mL (\u2265125 pg\/mL if AF\/flutter) in the presence of at least one structural cardiac abnormality) and HF with a mildly reduced fraction (HFmrEF, LVEF within 40\u201350% and either NT-proBNP \u2265 200 pg\/mL (\u2265600 pg\/mL if AF\/flutter) or BNP \u2265 100 pg\/mL (\u2265125 pg\/mL if AF\/flutter) in the presence of at least one structural cardiac abnormality). The significance threshold was set at p \u2264 0.001. Results: We analyzed 126,636 patients with a mean age of 52.2 (SD = 18.3) years, with 57% (n = 72,290) being female. The prevalence of HF was 2.1% (n = 2700). The HF patients\u2019 mean age was 74.0 (SD = 12.1) years, and 51.6% (n = 1394) were female. Regarding HF subtypes, HFpEF accounted for 65.4% (n = 1765); 16.1% (n = 434) had HFmrEF and 16.3% (n = 439) had HFrEF. The patients with HFrEF were younger (p &lt; 0.001) and had a history of myocardial infarction more frequently (p &lt; 0.001) compared to HFnrEF, with no other significant differences between the HF groups. The HFrEF patients were more frequently prescribed CV medications than HFnrEF patients. Type 2 Diabetes Mellitus (T2D) was present in 44.7% (n = 1207) of the HF patients. CKD was more frequently present in T2D vs. non-T2D HF patients at every stage (p &lt; 0.001), as well as stroke, peripheral artery disease, and microvascular disease (p &lt; 0.001). Conclusions: In this cohort, considering a contemporary definition, the prevalence of HF was 2.1%. HFrEF accounted for 16.3% of the cases, with a similar clinical\u2013epidemiological profile having been previously reported in the literature. Our study revealed a high prevalence of patients with HFpEF (65.4%), raising awareness for the increasing prevalence of this entity in cardiology practice. These results may guide local and national health policies and strategies for HF diagnosis and management.<\/jats:p>","DOI":"10.3390\/jcdd9050149","type":"journal-article","created":{"date-parts":[[2022,5,8]],"date-time":"2022-05-08T08:04:21Z","timestamp":1651997061000},"page":"149","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["20 Years of Real-World Data to Estimate the Prevalence of Heart Failure and Its Subtypes in an Unselected Population of Integrated Care Units"],"prefix":"10.3390","volume":"9","author":[{"given":"Cristina","family":"Gavina","sequence":"first","affiliation":[{"name":"Cardiology Department, Pedro Hispano Hospital, Senhora da Hora, 4464-513 Matosinhos, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5299-9341","authenticated-orcid":false,"given":"Daniel Seabra","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Cardiology Department, Pedro Hispano Hospital, Senhora da Hora, 4464-513 Matosinhos, Portugal"}]},{"given":"Filipa","family":"Valente","sequence":"additional","affiliation":[{"name":"Medical Department, Evidence Generation, AstraZeneca, 2730-097 Barcarena, Portugal"}]},{"given":"Filipa","family":"Bernardo","sequence":"additional","affiliation":[{"name":"Medical Department, Evidence Generation, AstraZeneca, 2730-097 Barcarena, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7430-6297","authenticated-orcid":false,"given":"Ricardo Jorge","family":"Dinis-Oliveira","sequence":"additional","affiliation":[{"name":"Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"TOXRUN\u2014Toxicology Research Unit, University Institute of Health Sciences, Advanced Polytechnic and University Cooperative (CESPU), CRL, 4585-116 Gandra, Portugal"},{"name":"UCIBIO-REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal"},{"name":"MTG Research and Development Lab, 4200-604 Porto, Portugal"}]},{"given":"Carla","family":"Santos-Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Nephrology Department, Pedro Hispano Hospital, Senhora da Hora, 4464-513 Matosinhos, Portugal"},{"name":"UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0998-6000","authenticated-orcid":false,"given":"Tiago","family":"Taveira-Gomes","sequence":"additional","affiliation":[{"name":"TOXRUN\u2014Toxicology Research Unit, University Institute of Health Sciences, Advanced Polytechnic and University Cooperative (CESPU), CRL, 4585-116 Gandra, Portugal"},{"name":"MTG Research and Development Lab, 4200-604 Porto, Portugal"},{"name":"Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, 4050-313 Porto, Portugal"},{"name":"Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal"},{"name":"Faculty of Health Sciences, University Fernando Pessoa (FCS-UFP), 4249-004 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1001\/jama.2020.10262","article-title":"Heart Failure with Reduced Ejection Fraction: A Review","volume":"324","author":"Murphy","year":"2020","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.repc.2017.11.010","article-title":"Insufici\u00eancia card\u00edaca em n\u00fameros: Estimativas para o s\u00e9culo XXI em Portugal","volume":"37","author":"Fonseca","year":"2018","journal-title":"Rev. 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