Abstract
Introduction. Chronic heart failure (CHF) remains one of the main health problems due to the high disability of the population and frequent repeated hospitalizations. The increase in the prevalence of CHF is due to an aging population and an increase in patient survival after acute cardiovascular disasters. In Almaty, the burden of this pathology is aggravated by the pronounced polymorbidity of outpatient patients. The synergistic effect of arterial hypertension, coronary artery disease, rhythm disturbances and concomitant renal dysfunction leads to frequent decompensation of blood circulation. In this regard, a comprehensive analysis of the 10-year dynamics of the primary incidence of CHF and the structure of the comorbid background in the metropolis. Aim. To evaluate the dynamics of the incidence of chronic heart failure and concomitant pathologies in Almaty in 2015-2024. Hypothesis: We assumed that over the past decade (2015-2024), the indicators of primary incidence of chronic heart failure and the structure of comorbidity in a large Central Asian metropolis (Almaty) will demonstrate trends similar to global epidemiological trends (in particular, data from Western and European ESC registries). These trends are characterized by an outstripping increase in morbidity among men and a steady shift towards severe forms of cardiorenal syndrome. In addition, we hypothesized that the rate of increase in concomitant renal failure and cardiac arrhythmias in outpatient patients in Almaty will exceed the global average due to the regional characteristics of the accumulation of cardiovascular risk factors. Materials and methods. The analysis of the indicators of the primary incidence of CHF and concomitant somatic pathologies (arterial hypertension, angina pectoris, myocardial infarction, cardiac arrhythmias, renal failure) was carried out according to the data of the Almaty branch of the National Scientific Center for Health Development over a 10-year period (2015-2024). The calculation of intensive indicators was carried out per 100 thousand population using Microsoft Excel, SPSS programs and JASP. Results. During the analyzed period, a twofold increase in the incidence of CHF among the male population of the metropolis was revealed (from 35.5 to 71.6 per 100,000), which led to an equalization of the gender balance by 2024 (54.9% of women and 45.1% of men). The comorbid background of patients has become significantly more complicated: there was a linear increase in the detection of angina pectoris by 49.9%, an increase in the frequency of cardiac arrhythmias by 2.5 times and an explosive increase in renal failure by 4.2 times (by 329.1%). The COVID-19 pandemic in 2020 acted as a trigger, causing a simultaneous historical maximum of CHF and concomitant catastrophes of target organs, forming a long-term post-reactive plume of morbidity. Conclusion. The revealed scale and progressive complication of the comorbidity structure of outpatient patients with CHF in Almaty justify the urgent need to optimize existing approaches at the PHC level. A significant increase in morbidity and a marked increase in the frequency of concomitant renal failure, angina pectoris, and rhythm disturbances dictate the expediency of strengthening early screening programs for target organs, improving follow-up algorithms, and introducing interdisciplinary approaches to reduce the risk of recurrent circulatory decompensation.