News Release 

Heart failure care must address patients' broader health if survival rates are to be improved

Research published in JAMA Cardiology today presents new evidence that might explain why the prognosis of heart failure patients has improved so little over the past decade

University of Oxford

Findings show that a decline in cardiovascular deaths has been offset by an increase in the number of deaths from infections and respiratory problems, highlighting the importance of focusing on patients' overall health rather than individual diseases.

The advanced age at which heart failure develops is also a factor. Survival has improved among young and middle-aged patients, but prolonging life in people older than 80 - who account for about half of all heart failure patients - remains very difficult.

An estimated 920,000 people are currently living with a diagnosis of heart failure in the UK. A host of new treatments, device therapies such as implantable defibrillators, and remodelled clinical teams introduced in recent years would be expected to reduce premature death among heart failure patients.

Dr Nathalie Conrad from The George Institute for Global Health, UK at the University of Oxford, who led the research, said: "Despite considerable improvements in heart failure care since the early 2000s, overall mortality rates in the UK have changed very little. We wanted to understand the underlying reasons for this to help develop more targeted therapies and public health strategies."

The research team tracked the death rate for 86,000 UK adults with heart failure in the year following their diagnosis, using information from the Clinical Practice Data Link. Overall, they found that the risk of death from cardiovascular causes declined by 27% over the 12-year study period, but this was offset by a 22% increase in the death rate from non-cardiovascular causes.

By 2013, the majority of deaths and hospitalisations among heart failure patients were due to non-cardiovascular causes, the major ones being: cancer (15% of all deaths); infections (13%); and respiratory conditions (12%).

As the population of the UK ages, more individuals will experience co-existing morbidities, i.e. multiple health conditions that impact life expectancy. Current heart failure treatment is intrinsically disease-centred and almost exclusively focuses on patients' cardiovascular health. To boost survival rates, future research and management strategies must address patient health in the round.

"Our evidence highlights that a broader perspective must be taken in approaching heart failure management; one that considers not only patients' cardiovascular health, but also the range of associated co-morbities they are likely to experience," said Conrad.

###

Publication of the findings coincides with Conrad's presentation at the European Society of Cardiology Congress in Paris.

The study was funded by the British Heart Foundation, the National Institute for Health Research through the Oxford Biomedical Research Centre, the Oxford Martin School at the University of Oxford, the UKRI's Global Challenges Research Fund, and the University of Bristol.

Notes for editors

For journalists who wish to receive an embargoed copy of the paper, please email mediarelations@jamanetwork.org who will issue.

Once the embargo has lifted, the paper will be available from this URL: https://jamanetwork.com/journals/jamacardiology/fullarticle/10.1001/jamacardio.2019.3593

Media enquiries

Ana Bow-Bertrand
Communications Manager
The George Institute for Global Health, University of Oxford
Tel: 07918 553680
anastasia.bow-bertrand@georgeinstitute.ox.ac.uk

About The George Institute for Global Health

The George Institute for Global Health conducts clinical, population and health system research aimed at changing health practice and policy worldwide. The Institute has a global network of medical and health experts working together to address the leading causes of death and disability. Established in Australia and affiliated with UNSW Sydney, the Institute today also has offices in China, India and the United Kingdom. The George Institute UK was established in 2010 in partnership with the University of Oxford.

Facebook at thegeorgeinstitute Twitter @GeorgeInstUK Web georgeinstitute.org.uk

The National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC) is based at the Oxford University Hospitals NHS Foundation Trust and run in partnership with the University of Oxford. The NIHR is the nation's largest funder of health and care research. The NIHR:

  • Funds, supports and delivers high quality research that benefits the NHS, public health and social care
  • Engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
  • Attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
  • Invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
  • Partners with other public funders, charities and industry to maximise the value of research to patients and the economy

The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR supports applied health research for the direct and primary benefit of people in low- and middle-income countries, using UK aid from the UK government. This work uses data provided by patients and collected by the NHS as part of their care and support and would not have been possible without access to this data. The NIHR recognises and values the role of patient data, securely accessed and stored, both in underpinning and leading to improvements in research and care.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.