Clinical Profile of Heart Failure Patients and Evaluation of the Prescribing Practice of Guideline Directed Medical Therapy (GDMT) at Rwanda Military Referral and Teaching Hospital: A Retrospective Study.

BACKGROUND

Heart failure (HF) poses an increasing public health burden in Sub-Saharan Africa (SSA), where non-communicable diseases, particularly cardiovascular conditions, are contributing significantly to morbidity and mortality. In Rwanda, data on the distribution of HF subtypes and the use of guideline-directed medical therapy (GDMT) remain limited. This study aimed to describe the clinical profiles of HF patients at Rwanda Military Referral and Teaching Hospital (RMRTH) and evaluate physician adherence to GDMT in routine clinical practice.

METHODS

A retrospective review was conducted for all adult patients (≥18 years) diagnosed with HF and managed at the internal medicine unit of RMRTH between March 2022 and September 2023. Data were extracted from electronic health records and patient files. Descriptive statistics were performed using SPSS version 27.

RESULTS

The study included 108 patients, of whom 57.4% were female. The mean age was 59.2 ± 21.7 years. Most patients were from Kigali (51.9%) and the Eastern Province (29.6%). Among the cohort, 38.9% had HF with reduced ejection fraction (HFrEF), 32.4% had preserved ejection fraction (HFpEF), 13.0% had mid-range ejection fraction (HFmrEF), and 10.2% had isolated right heart failure. Hypertension (30.5%) was the most common comorbidity, followed by atrial fibrillation (15.7%) and diabetes mellitus (13.0%). Adherence to GDMT was suboptimal, with notable gaps in prescribing patterns across medication classes.

CONCLUSION

HFrEF is the most common HF subtype at RMRTH. Findings highlight the need to improve GDMT implementation. Further national-level studies are warranted to strengthen heart failure care in Rwanda.