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About the Authors:
Claire A. Lawson
Roles Conceptualization, Formal analysis, Investigation, Methodology, Project administration, Software, Visualization, Writing - original draft
* E-mail: [email protected]
Affiliation: Diabetes Research Centre, Leicester University, Leicester, United Kingdom
ORCID http://orcid.org/0000-0003-0127-5236
Ivonne Solis-Trapala
Roles Conceptualization, Formal analysis, Methodology, Supervision, Writing - review & editing
Affiliation: Institute for Applied Clinical Sciences, Keele University, Keele, United Kingdom
Ulf Dahlstrom
Roles Data curation, Writing - review & editing
Affiliations Department of Medical and Health Sciences, Linköping University, Linköping, Sweden, Department of Cardiology, Linköping University, Linköping, Sweden
Mamas Mamas
Roles Conceptualization, Investigation, Resources, Writing - review & editing
Affiliation: Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute of Primary Care and Health Sciences, Keele University, Keele, United Kingdom
Tiny Jaarsma
Roles Conceptualization, Data curation, Writing - review & editing
Affiliations Department of Social and Welfare Studies, Linköping University, Linköping, Sweden, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
ORCID http://orcid.org/0000-0002-4197-4026
Umesh T. Kadam
Roles Conceptualization, Formal analysis, Investigation, Methodology, Supervision, Visualization, Writing - review & editing
¶‡ These authors are joint senior authors on this work.
Affiliation: Diabetes Research Centre, Leicester University, Leicester, United Kingdom
ORCID http://orcid.org/0000-0002-4433-2977
Anna Stromberg
Roles Conceptualization, Data curation, Investigation, Methodology, Writing - review & editing
¶‡ These authors are joint senior authors on this work.
Affiliations Department of Medical and Health Sciences, Linköping University, Linköping, Sweden, Department of Cardiology, Linköping University, Linköping, SwedenAbstract
Background
Optimally treated heart failure (HF) patients often have persisting symptoms and poor health-related quality of life. Comorbidities are common, but little is known about their impact on these factors, and guideline-driven HF care remains focused on cardiovascular status. The following hypotheses were tested: (i) comorbidities are associated with more severe symptoms and functional limitations and subsequently worse patient-rated health in HF, and (ii) these patterns of association differ among selected comorbidities.
Methods and findings
The Swedish Heart Failure Registry (SHFR) is a national population-based register of HF patients admitted to >85% of hospitals in Sweden or attending outpatient clinics. This study included 10,575 HF patients with patient-rated health recorded during first registration in the SHFR (1 February 2008 to 1 November 2013). An a priori health model and sequences-of-regressions analysis were used to test associations among comorbidities and patient-reported symptoms, functional limitations,...