Thousands of UK heart failure deaths could be prevented, according to new survey

Cardiology

Thousands of UK heart failure deaths could be prevented, according to new survey

4 February 2005

LONDON. One of the largest surveys ever undertaken on heart failure shows that inadequate awareness, diagnosis and treatment may be contributing to thousands of preventable deaths every year. In the UK, heart failure claims at least 24,000 lives each year.(1)

The SHAPE survey, initiated by a group of independent medical specialists, shows a widespread lack of knowledge on heart failure, a condition which affects more than a million people in the UK(1). Although 93 percent of the UK population had heard of heart failure, just two percent could identify the signs and symptoms of the disease. This could mean delayed visits to the doctor for diagnosis and treatment, resulting in much lower survival rates.

In addition, more than 65 percent of the public wrongly thought that survival rates with heart failure were better than with cancer. The chance of surviving for five years following diagnosis with heart failure is just 25 percent for men and 38 percent for women, lower than for most cancers.(2,3)

Heart failure was thought by 29 percent of respondents to be a natural consequence of ageing, yet 40 percent of heart failure patients die within one year of first hospitalisation, the opposite of a gentle decline into old age.

Commenting on the results, Professor Hobbs, GP and Professor of Primary Care and General Practice at the University of Birmingham said: "A 40 year old man or woman has a one in five chance of developing heart failure and every year it is likely that there are more than 100,000 new cases of heart failure in the UK. The prevalence of the disease is increasing. We need to increase public understanding, because early diagnosis, along with proper treatment and lifestyle modification would mean that many patients with heart failure could not only live longer but also enjoy a better quality of life."

A parallel survey of UK doctors revealed that only 22 percent of doctors are prescribing optimal treatment to patients following diagnosis. Although most physicians recognised the symptoms of heart failure, three quarters of GPs do not use additional tests, such as echocardiography, which are recommended in the SIGN(4) and NICE guidelines(5) to accurately confirm diagnosis.

Professor McMurray, cardiologist and Professor of Medical Cardiology at the University of Glasgow stated: "I would like to see UK GPs adhering more closely to treatment guidelines. ACE inhibitors are recommended as first-line therapy, yet, according to SHAPE only 36 percent start treatment with an ACE inhibitor (with or without a diuretic). Guidelines also recommend adding a beta-blocker if symptoms persist. However, only 24 percent of GPs currently do this."

879 members of the public were interviewed in the UK for the SHAPE survey, in addition to 372 UK-based physicians.
Heart failure costs the NHS around £625 million every year.(6)

More information can be found at www.heartfailure-europe.com

Background

1. SHAPE (the Study group on Heart failure Awareness and Perception in Europe) was established in 2002 by an independent group of medical specialists.

2. SHAPE's aim is to improve heart failure care across Europe, by increasing public awareness and perception of the disease.

3. To achieve this aim, SHAPE has initiated an educational programme on heart failure. SHAPE is also involved in lobbying governments and healthcare providers across Europe to make greater resources available for improved the care of people with heart failure.

4. SHAPE is the only European organisation exclusively dedicated to improving heart failure care in General Population and Health Care Providers.

5. Nine countries, representing Northern, Central, Southern and Western Europe, are involved in the SHAPE initiative: France, Germany, Italy, The Netherlands, Poland, Romania, Spain, Sweden and the United Kingdom.

6. The SHAPE project is being co-ordinated by the Sticares Cardiovascular Research Foundation, an international scientific research organisation, which coordinates and performs clinical and epidemiological studies, aimed at the prevention and/or better treatment of cardiovascular disorders.

References:

1. Murdoch DR et al. Importance of heart failure as a cause of death. Changing contribution to overall mortality and coronary heart disease mortality in Scotland 1979-1992. Eur Heart J. 1998 Dec;19(12):1829-35.

2. Ho KK et al. Survival after the onset of congestive heart failure in Framingham Heart Study subjects. Circulation 1993; 88: 107-15

3. Stewart S et al. More 'malignant' than cancer? Five year survival following a first admission for heart failure. The European Journal of Heart Failure 2001; 3: 315-322

4. SIGN National Clinical Guideline: Diagnosis and Treatment of Heart Failure due to Left Ventricular Systolic Dysfunction. 1999

5. Cowie MR. NICE guidelines on heart failure. Clin Med 2003; 3: 399-401

6. Stewart S, Jenkins A, Buchan S, McGuire A, Capewell S, McMurray JJ. The current cost of heart failure to the National Health Service in the UK. Eur J Heart Fail. 2002 Jun;4(3):361-71.

Source: SHAPE