Patterns of comorbidity in older adults with heart failure: the Cardiovascular Research Network PRESERVE study

J Am Geriatr Soc. 2013 Jan;61(1):26-33. doi: 10.1111/jgs.12062.


Objectives: To examine whether the total burden of comorbidity and pattern of co-occurring conditions varies in individuals with heart failure (HF) with preserved left ventricular ejection fraction (LVEF) (HF-P) or HF with reduced LVEF (HF-R).

Design: Cross-sectional cohort study.

Setting: Four participating health plans within the National Heart, Lung, and Blood Institute-sponsored Cardiovascular Research Network.

Participants: All members aged 65 and older with HF based on hospital discharge and ambulatory visit diagnoses.

Measurements: Participants with a LVEF of 50% or greater were classified as having HF-P. Presence of cardiac and noncardiac comorbidities was obtained from health plan administrative databases.

Results: Of 23,435 individuals identified with HF and LVEF information, 53% (12,407) had confirmed HF-P (mean age 79.6; 60% female). More than three-quarters of the sample had three or more co-occurring conditions in addition to HF, and half had five or more cooccurring conditions. Participants with HF-P had a slightly higher burden of comorbidity than those with HF-R (mean 4.5 vs 4.4, P = .002). Patterns of how specific conditions co-occurred did not vary in participants with preserved or reduced systolic function.

Conclusion: There is a high degree of comorbidity and multiple morbidity in individuals with HF. The burden and pattern of comorbidity varies only slightly in individuals with preserved or reduced LVEF.

Publication types

  • Historical Article
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Comorbidity / trends
  • Cross-Sectional Studies
  • Digestive System Diseases / epidemiology*
  • Female
  • Follow-Up Studies
  • Heart Failure / epidemiology*
  • Heart Failure / physiopathology
  • History, Ancient
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Neoplasms / epidemiology*
  • Retrospective Studies
  • Stroke Volume
  • United States / epidemiology
  • Young Adult