Impact of the sustained control of cardiovascular risk factors on first episode heart failure: The relevant role of primary care

Figures & data

Figure 1. Follow-up chart showing the enrolment period of all participants according to inclusion date.

Table 1. Differences in cardiovascular comorbidity between individuals admitted to hospital because of a first heart failure episode and those without heart failure, after the matching process.

	Cases (heart failure) n = 129 n (%)	Controls (free from heart failure) n = 516 n (%)	P value
Comorbidity
Smoker	20 (15.5)	58 (11.2)	0.184
Dyslipidaemia	57 (44.2)	230 (44.6)	0.937
Hypertension	87 (67.4)	363 (70.3)	0.52
Coronary heart disease	23 (17.8)	72 (14.0)	0.267
Diabetes	47 (36.4)	215 (41.7)	0.279
Stroke	11 (8.5)	47 (9.1)	0.836
Sex
Male	68 (52.7)	268 (51.9)	0.875
Female	61 (47.3)	248 (48.1)

SD, standard deviation.

Table 2. Differences in cardiovascular risk factor levels and their control between individuals admitted to hospital because of a first heart failure episode (cases) and those free from heart failure (controls), according to the time elapsed before the date of inclusion. (The inclusion date was determined by the hospital admission of the corresponding cases.).

	Last 12 months before the date of inclusion					Between 24 and 13 months before the date of inclusion
	Cases (heart failure episode) n = 129		Controls (free from heart failure) n = 516			Cases (heart failure episode) n = 129		Controls (free from heart failure) n = 516
Variable	Mean	SD	Mean	SD	P value	Mean	SD	Mean	SD	P value
Body mass index	33.0	6.2	29.8	5.4	0.001	33.4	6.9	30.0	5.1	< 0.001
Heart rate	76.1	10.9	73.6	11.6	0.133	74.9	11.8	73.0	10.9	0.279
Systolic blood pressure	142.2	20.6	135.4	14.4	0.001	138.6	17.8	136.7	16.3	0.413
Diastolic blood pressure	76.2	10.0	73.0	8.9	0.009	75.9	8.0	74.6	9.2	0.331
Blood pressure uncontrolled (%)^a	44.0%		34.0%		0.12	45.6%		42.9%		0.713
Glycosylated haemoglobin	7.3	1.6	6.9	1.3	0.173	7.3	2.1	6.5	1.2	0.011
Glycosylated haemoglobin ≥ 7 (%)	58.0%		36.5%		0.029	38.1%		24.7%		0.209
Fasting blood glucose	133.6	53.3	128.7	41.4	0.491	153.9	58.0	125.2	33.3	< 0.001
Total cholesterol	186.8	42.8	198.2	39.9	0.059	191.7	43.0	199.0	40.2	0.322
HDL cholesterol	46.5	10.5	52.7	14.0	0.004	47.0	12.5	53.8	14.3	0.016
LDL cholesterol	114.7	33.9	120.8	33.7	0.264	111.0	35.0	121.1	34.3	0.154
Lipids uncontrolled (%) LDL ≥ 115)	50.0%		52.7%		0.734	39.3%		54.6%		0.131
Triglycerides	145.2	71.8	128.2	58.6	0.072	197.8	150.8	126.9	61.7	< 0.001
Renal function (creatinine)	1.0	0.3	1.0	0.4	0.246	1.0	0.3	1.0	0.3	0.406

HDL, high density lipoprotein; LDL, low density lipoprotein.

^aSystolic blood pressure ≥ 140 and/or diastolic blood pressure ≥ 90 mmHg.

Figure 2. Flow chart showing the participants’ selection process.

Table 3. Crude and adjusted odds ratio for the first heart failure hospital admission episode according to previous clinical determinations. ORs have been calculated according to the variation for each unit of the corresponding variables.

Variable	OR adjusted	95% CI	P value	OR crude	95% CI	P value
Time: 12 months before heart failure episode
Body mass index (kg/m^2)	1.06	(0.99–1.13)	0.072	1.09	(1.03–1.15)	0.005
Heart rate (beat/min)	1.02	(1.00–1.05)	0.074	1.02	(1.00–1.05)	0.055
Systolic blood pressure (mm/Hg)	1.03	(1.01–1.04)	0.006	1.03	(1.01–1.04)	< 0.001
Diastolic blood pressure (mm/Hg)	1.02	(0.98–1.05)	0.351	1.04	(1.01–1.07)	0.002
HDL cholesterol (mg/dl)	0.95	(0.92–0.98)	0.005	0.95	(0.92–0.98)	0.001
LDL cholesterol (mg/dl)	1.00	(0.99–1.01)	0.469	0.99	(0.99–1.00)	0.226
Time: between 24 and 13 months before heart failure episode
Body mass index (kg/m^2)	1.08	(1.01–1.15)	0.022	1.09	(1.04–1.16)	0.001
Heart rate (beat/min)	1.02	(0.99–1.05)	0.159	1.02	(1.00–1.05)	0.086
Systolic blood pressure (mm/Hg)	1.01	(0.99–1.03)	0.274	1.01	(0.99–1.03)	0.263
Diastolic blood pressure (mm/Hg)	1.00	(0.97–1.04)	0.798	1.02	(1.00–1.05)	0.1
HDL cholesterol (mg/dl)	0.97	(0.94–1.00)	0.064	0.97	(0.94–1.00)	0.028
LDL cholesterol (mg/dl)	1.00	(0.99–1.01)	0.578	0.99	(0.99–1.00)	0.280

OR adjusted, odds ratio adjusted by logistic model by presented variables; OR crude, odds ratio without adjustment; 95% CI, 95% confidence interval; HDL, high-density lipoprotein; LDL, low-density lipoprotein