Older women who have less social support and live in nursing homes are more likely to have heart failure with preserved systolic function than those who are married or living in their own home, according to the results of research published in the Medical Journal of Australia.
Dr Sepehr Shakib, from the Royal Adelaide Hospital, and his co-authors, including cardiologists Dr Dennis Wong and Dr Ben Dundon with social epidemiologist Dr Robyn Clark from the Samson Institute, University of South Australia, undertook a retrospective analysis of clinical data for 2961 patients admitted with chronic heart failure over a period of 10 years.
The authors found patients who had heart failure with preserved systolic function (HFPSF) were predominantly older women with less social support and a greater burden of comorbid conditions such as renal impairment, anaemia and atrial fibrillation compared with those with left ventricular systolic dysfunction.
There was also an increase in the risk of re-hospitalisation among patients with HFPSF.
Dr Shakib said lack of social and carer support and a greater burden of comorbid conditions in patients with HFPSF may have played a significant predisposing role in hospitalisation and readmissions.
"Our study is the first to identify significant differences in the social environment of these patients," Dr Shakib said.
"We propose that the burden of reduced survival in HFPSF may relate more to comorbid conditions than suboptimal cardiac management."
In an accompanying editorial in the MJA, Prof Peter MacDonald, Conjoint Professor of Medicine at the University of New South Wales, writes that there is an urgent need to gain a better understanding of the pathogenesis of HFPSF in order to identify additional preventive and treatment approaches.
Prof MacDonald said this would be particularly challenging in a population exposed to multiple comorbid conditions, increasing physical frailty and social isolation.
"Optimal management of these patients will require a multidisciplinary approach with the general practitioner taking the central role," he said.
The Medical Journal of Australia is a publication of the Australian Medical Association.