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ARTICLE |

Precipitating Factors Leading to Decompensation of Heart Failure:  Traits Among Urban Blacks

Jalal K. Ghali, MD; Sunil Kadakia, MD; Richard Cooper, MD; Jack Ferlinz, MD
Arch Intern Med. 1988;148(9):2013-2016. doi:10.1001/archinte.1988.00380090087021.
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• Potential precipitating factors that led to cardiac decompensation and subsequent hospital admission for heart failure were examined in 101 patients in a large public hospital serving a predominantly working-class minority population. Ninety-seven percent of patients were black; their age was 59± 14 years (mean ±SD); on average, they were hospitalized three times in the preceding year for problems related to their heart failure. Potential precipitating factors for decompensated heart failure were identified in 93% of patients. Lack of adherence to the prescribed medical regimen was the most commonly identified causative factor and was noted in 64% of the cases; noncompliance with diet amounted to 22%, with drugs to 6%, and with the combination of drugs and diet to 37%. Other factors also related to hospitalization were cardiac arrhythmias (29%), emotional/environmental issues (26%), inadequately conceived drug therapy (17%), pulmonary infections (12%), and thyrotoxicosis (1%). Thus, the key preventive measure necessary in at least two thirds of patients centered around better adherence to drug and/or diet regimen, highlighting the precept that better patient education is mandatory if we are to minimize the number of hospital admissions for decompensated heart failure.

(Arch Intern Med 1988;148:2013-2016)

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