Heart failure

Heart failure snapshot: not a pretty picture

Heart failure is predicted to affect 657,000 people by 2025 yet not enough is being done to prevent or manage the chronic condition.

Professor Simon Stewart, director of the NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease at the Australian Catholic University, told the limbic heart failure suffered from not being one of the ‘popular’ conditions.

“Public health policy is often driven by popular opinion and does not reflect the burden of disease. We need a more pragmatic, ethical and logical distribution of health funds,” he said.

He said strategies such as aggressive treatment to blood pressure targets were needed. There was evidence that while blood pressure treatments can have a dramatic effect on hypertension, ‘patient and clinician fatigue’ tended to set in after a few visits and early gains were lost.

“Even though they are not achieving targets, we find no up-titration of treatment. Inertia sets in. We need to find ways to engage patients and keep treating them aggressively from a prevention point of view.”

“Critical components of blood pressure targeting in primacy care include the involvement of practice nurses yet there are no reimbursement items for that.”

Using medical specialists wisely was another way to disrupt the inertia, he said.

Professor Stewart coauthored the Snapshot of Heart Failure in Australia Report, which found heart failure was responsible for about 158,000 hospital admissions and 1.1 million inpatient days at a direct cost of about $2 billion per year.

The report said about one third of all heart failure-related hospital admissions were preventable. As well, a third of patients who survived an initial heart failure-related admission were likely to be readmitted within 30 days.

Most were likely to experience three readmissions within the next year.

“If done well with multidisciplinary teams, heart failure services can improve prognosis and risk of hospital admissions and readmissions,” Professor Stewart said.

The report found heart failure was a disproportionate burden in the Northern Territory, driven by poor health in the Indigenous population, and in Tasmania and regional hotspots driven largely by low socioeconomic status.

It said there were 61,000 heart failure-related deaths each year.

The report is an extension of research published last year on the burden of heart failure in Australia.

The Snapshot report was funded by Novartis. Its angiotensin receptor neprilysin inhibitor Entresto (sacubitril with valsartan) is available on the PBS from June 1.


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