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Rise in heart failure case means numbers now equal ‘four most common cancers combined’

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The number of new cases of heart failure is on the up, with striking differences between rich and poor, shows the most comprehensive review of heart failure statistics in the UK to date.

Between 2002 and 2014, the number of new cases of heart failure increased by 12%, according to the review that shows numbers are now similar to new cases of breast, prostate, lung and bowel cancer combined.

“Our findings have important implications for healthcare resource planning and prevention strategies”

Kazem Rahimi

Conducted by leading universities and research institutions, it warns of increased pressure on already over-stretched services and calls for more effort to tackle huge disparities between the least well off and most affluent members of society.

The study, which is said to be the largest investigation of its kind, brings together data from primary and secondary care. Researchers reviewed the records of more than 3.9 million patients over 13 years, including people newly-diagnosed with heart failure and those already living with the condition.

The review found that rates of heart failure have actually gone down or remained relatively stable in recent years, thanks to better prevention such as smoking cessation and lifestyle advice often provided by nurses, and better management of heart attacks, high blood pressure and diabetes.

Between 2002 and 2014, the rate of heart failure dropped by 7% from 358 cases per 100,000 people to 332 per 100,000.

The overall prevalence remained stable over this period, but the number of existing heart failure cases increased substantially by 23% from more than 750,000 to more than 920,000 – probably because people are living longer after being hit by a heart attack or other heart issues.

However, factors such as an ageing and growing population mean the overall number of new diagnoses has increased.

“Our findings have important implications for healthcare resource planning and prevention strategies, as the number of people affected by heart failure grows and places an ever-greater burden on health services,” said Professor Kazem Rahimi, from the University of Oxford.

“To counter this, we need stronger public health action in disease prevention, improved resource planning, and efficient and effective care for newly-diagnosed patients and those surviving heart failure,” he said.

The researchers looked at medical and social factors, such as blood pressure, body mass index, whether they smoked, and any other chronic conditions they had as well as socioeconomic status, ethnicity and where they lived.

One of the most striking findings was the difference in the incidence of heart failure among rich and poor, with people from the most deprived backgrounds being 61% more likely to experience heart failure than people from the most affluent backgrounds.

“Achieving equal access and use of healthcare is an important goal”

Kazem Rahimi

The least well off were about 3.5 years younger when they experienced heart failure than their well off counterparts, according to the findings published this week in The Lancet.

Meanwhile, people from deprived backgrounds were also more likely to have other chronic health conditions, according to the findings of the review, which was funded by the British Heart Foundation and National Institute for Health Research.

The proportion of patients with three or more additional chronic health conditions ranged from 81% for the most deprived to 77% for the least deprived.

The study authors calculated that if these inequalities could be removed then there would be more than 31,000 fewer cases of heart failure annually in the UK.

“The disparities we have identified in the UK point to a potentially preventable nature of heart failure that still needs to be tackled, and to potential opportunities for more targeted and equitable prevention strategies,” said Professor Rahimi.

He added: “Achieving equal access and use of healthcare is an important goal, and in this instance could help to tackle the biological, environmental and behavioural risk factors that put people from more deprived background at greater risk of heart failure.”

The review also highlighted changes in the type of people facing heart failure over time. For example, the average age of people with heart failure has increased from 76.5 to 77 years old.

There was also a substantial increase in the number of other chronic conditions patients had, from an average of 3.4 additional chronic conditions in 2002 to 5.4 in 2014.

The researchers said this showed the treatment of heart failure was becoming more complex and this too placed extra pressure on health services.

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