Prevalence and characterization of heart failure in Aragon, Spain (ICAR study).

Introduction: Heart failure (HF) imposes a significant clinical and care burden. The ICAR study sought to address the absence of recent population estimates and an integrated approach to the diagnosis of HF in Spain, specifically in the region of Aragon. Methods: Population-based, observational, retrospective, descriptive cross-sectional study conducted over a 5-year period (2019-2023) in Aragon. It included individuals residing in the region aged ≥18 years with HF and was based on BIGAN database. Results: We identified 30 677 individuals with HF (prevalence 2.7%). Prevalence increased with age (>75 years, 72.3%) and was higher in women (2.8% vs. 2.6%). Mean time since diagnosis was 6.6 years (standard deviation: 5.9). The main comorbidities were hypertension (63.5%); dyslipidemia (48.9%); obesity (39.5%); chronic kidney disease (35.4%); atrial fibrillation (34.0%); diabetes (32.3%); and anemia (30.6%). Diagnosis was primarily hospital-based: ∼33% were diagnosed exclusively during the hospital stay, ∼20% in primary care, and ∼45% across different levels of care. We observed a more than four-fold increase in hospital admissions in patients with HF and an approximately 45% increase in emergency visits for HF between 2019 and 2023. The main treatments prescribed were loop diuretics (57.5%), while the most common for HF were beta-blockers (47.4%), angiotensin receptor blockers (37.0%), mineralocorticoid receptor antagonists (23.5%), sodium-glucose cotransporter type 2 inhibitors (22.5%), angiotensin-converting enzyme inhibitors (17.7%), and sacubitril/valsartan (8.9%). Conclusion: HF in Aragon shows high prevalence and complexity in an aging population with multiple pathologies, in the framework of a reactive care model characterized by in-hospital confirmation and rising resource utilization.