Burden of comorbidities in heart failure patients in Türkiye

Abstract

Background/aim: Heart Failure (HF) is associated with a wide range of comorbidities that negatively impact on clinical outcomes and cause to high economic burden. We aimed to evaluate frequency and burden of comorbidities in HF patients in Türkiye and their relationship with the patient's demographic characteristics.Materials and methods: Based on ICD-10 codes in National Electronic Database of the Turkish Ministry of Health, covering the entire population of Türkiye (n=85,279,553), from January 1, 2016, to December 31, 2022, prevalence of comorbidities in HF patients were obtained. Frequency and burden of comorbidities were analyzed separately by age groups, gender and socioeconomic status (SES).Results: Between 2016 and 2022, there were 2,722,151 patients (51.7% female) of all ages who were diagnosed with HF. In Türkiye, the most common comorbidities in HF patients were hypertension (HT) (97.6%), atherosclerotic cardiovascular disease (ASCVD) (84.9%), dyslipidemia (59.5%), anxiety disorder (48.1%), diabetes mellitus (DM) (45.2%), chronic obstructive pulmonary disease (COPD) (43.6%), anemia (40.6%), and atrial fibrillation (AF) (37.1%). Females had a higher rate of anemia, DM, HT and anxiety disorders, while males had a higher rate of ASCVD, COPD, and dyslipidemia. The most common comorbidity in patients under 20 years of age was congenital heart disease (52.3%). More than 90% of HF patients have had ≥2 comorbidities. HF patients with ≥5 comorbidities increased from 18.1% in the group with 20-49 years of age to 38.3% in the group with 50-79 years of age. Comorbidities were similar across the SES groups.Conclusion: The most common comorbidities in HF in Türkiye are HT, ASCVD, dyslipidemia, DM, COPD, anemia and AF, respectively, and more than 90% of patients have ≥2 comorbidities. While ASCVD and dyslipidemia were more common in men; anemia, DM and anxiety disorders were more common in women. The number of comorbid conditions increases with advanced age.