# Frequency of Anemia in Patients With Heart Failure With Preserved Ejection Fraction (HFpEF)

## TL;DR

This study finds that anemia is common in heart failure patients with preserved ejection fraction, especially among older women and those with diabetes or hypertension.

## Contribution

The study provides new insights into the high prevalence of anemia in HFpEF patients in Pakistan and its associations with age and comorbidities.

## Key findings

- Anemia was detected in 76% of HFpEF patients.
- Anemia was more common in elderly patients and females.
- Anemia was frequently associated with diabetes and hypertension.

## Abstract

Background: Cardiovascular disease remains a major health burden in Pakistan, with heart failure (HF) contributing substantially to morbidity. Anemia is a common yet underrecognized comorbidity in patients with heart failure with preserved ejection fraction (HFpEF).

Objective: The primary objective of this study is to determine the frequency of anemia in patients with HFpEF and the secondary objectives are to (i) assess the association between anemia and clinical comorbidities, including hypertension, diabetes mellitus, and chronic kidney disease, and (ii) evaluate the relationship between anemia and markers of HF severity, including NT-proBNP, E/e′ ratio, and left ventricular ejection fraction.

Methodology: From June to December 2024, a prospective cross-sectional study was conducted at Liaquat National Hospital, involving patients diagnosed with HFpEF. Participants were recruited through purposive non-probability sampling from the tertiary heart failure inpatient department. Data of various clinical and demographic variables were systematically recorded using a pre-designed proforma.

Results: Among 102 HFpEF patients, the mean age was 67.38 ± 8.99 years. Female patients comprised 58.8% (n = 60), while male patients accounted for 41.2% (n = 42). Anemia was detected in 76% (n = 72) of the population. Diabetes mellitus was present in 57.8% (n = 59) and hypertension in 84.3% (n = 86) of participants. Within the anemic subgroup (n = 78), 75% (n = 59) were elderly, and female patients represented the majority, indicating a gender- and age-linked predisposition.

Conclusion: Anemia is highly prevalent among HFpEF patients and is commonly associated with advanced age and comorbid conditions, highlighting the need for routine screening and early management to improve clinical outcomes.