Features of Congestive Heart Failure in Moroccan Elderly Patients

Abstract

Introduction: Congestive heart failure (CHF) is associated with aging-related diseases. CHF in African elderly is a severe and frequent condition, responsible for a high mortality and hospitalization rate. However very few studies report particularities of CHF in this population. This study aims to characterize clinical and therapeutic features of CHF in the elderly in the region of Casablanca Morocco. Methods: It’s a transversal retrospective study conducted over 13 years, [May 2006- June 2019] covering all CHF patients beyond 14 years old, followed-up in the HF therapeutic unit of the cardiology department of Casablanca University hospital. We studied features of CHF among elderly patients (>= 65 years) compared with younger patients. Results: Among 3412 patients, elderly patients accounted for 1701 (49.8%) with male predominance (62.5 %). 26,7% were smokers, 44.9% hypertensive, 31,6% diabetic, and 9,8% had dyslipidemia. In elderly vs youngsters: Ischemic-heart-disease was the most common etiology 59,9%vs57,4%, followed by non-ischemic-dilated-cardiomyopathy 9,4%vs1,2% and valvular heart disease 2.9%vs4,5%, P<0,001. Dyspnea stage III-IV was found in 25.5%vs7.2%, P <0,001. Elderly patients presented more clinical signs of HF, more atrial fibrillation, more cerebral stroke and were more likely to present chronic kidney disease. Mean LVEF was 36,18+10,34% vs 36+-9,88%, P:0,649. Critical elevation Doppler-filling-pressures was found in 22,5%vs18,3%, P:0,003. Therapeutically, ACE has been used in 78,50%,  AT-II-receptor-antagonists in 7,47%, Beta-blockers in 80,32%, Furosémide in 46,64%, Spirinolactone in 58.2% and Ivabradine  in 3,82%. The re- hospitalization rate in elderly patients was 53,5% vs 43,2%, P <0,001. Conclusion: CHF is a major public health problem in Morocco and AFRICA in general. It’s a major cause of death and re-hospitalization among elderly patients. Therefore, health strategies need to be accustomed and adjusted to the elderly patients in order to implant an optimal and appropriate therapeutic treatments.