Characterization of dyspnea in chronic diseases and heart failure in patients in a Family Health Program

Background Dyspnea is the most common symptom in heart failure. In the elderly, it is common in chronic obstructive pulmonary disease and depression. Objective To estimate the prevalence of dyspnea on exertion, orthopnea and paroxysmal nocturnal dyspnea and its association with chronic diseases in primary care. Methods A cross-sectional study, part of the Digitalis Study, including 633 individuals, between 45 to 99 years old, registered in a primary care program in Niteroi, Brazil. All participants underwent clinical evaluations, blood and urine collection, and responded to a questionnaire in a single day. Self-reports were used for the diagnosis of diseases. Results Of the 633 individuals, 30% had dyspnea. In the crude analysis, chronic obstructive pulmonary disease showed the strongest associations with the three types of dyspnea, followed by depression and heart failure. Chronic obstructive pulmonary disease alone did not present any cases of paroxysmal nocturnal dyspnea, and heart failure alone showed a very strong relationship with this type of dyspnea. Conclusions The different behavior of the associations of the types of dyspnea with major chronic diseases in patients in primary care can help in the better characterization of patients with heart failure.