Only ‘modest’ improvement in heart failure survival rates since 2000

Research published in the BMJ shows that there has only been a minor improvement in heart failure survival rates since the year 2000

According to a study published in the BMJ, survival of heart failure has only risen modestly in recent years, leading the study’s researchers to call for further investment in research in this year.

Heart failure survival rates are worse for people requiring admission to hospital near the time of diagnoses. It is also worse for patients from deprived backgrounds.

Unlike cancer, heart failure has not been a priority for government policy or funding. The researchers say that their study’s results “should alert policy makers to the need for further investment in heart failure services.”

Heart failure is an increasingly common condition that affects over 920,000 people in the UK, and globally is estimated to cost £82.4bn each year.

Reliable survival estimates are important for any long-term condition, yet studies exploring survival trends for heart failure over time are inconsistent.

The research team, led by Dr Clare Taylor and Professor Richard Hobbs at the Nuffield Department of Primary Care Health Sciences in Oxford, set out to report short and long-term survival rates of people with heart failure, and to examine trends over time by year of diagnosis, hospital admission around the time of diagnosis and socio-economic group.

Using UK primary care data from 2000 to 2017 linked to hospital and mortality records, the researchers compared survival rates for 55,959 patients aged 45 and over with a new diagnosis of heart failure with 278,679 matched controls.

They defined heart failure as people with a new diagnosis of heart failure in their medical record during the study period. Hospital data revealed whether a patient was admitted to hospital within three months of diagnosis.

Overall, one, five, and 10-year survival rates increased by 6.6% (from 74.2% in 2000 to 80.8% in 2016), 7.2% (from 41.0% in 2000 to 48.2% in 2012), and 6.4% (from 19.8% in 2000 to 26.2% in 2007), respectively.

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Of 30,906 deaths in the heart failure group over the study period, heart failure was listed on the death certificate in 13,093 (42.4%) of these patients, and in 2,237 (7.2%) it was the primary cause of death.

Improvement in survival was on average 2.4 years greater for patients not requiring admission to hospital around the time of diagnosis (5.3 v 2.9 years), which the researchers say probably relates to a more advanced stage of disease.

This is an observational study, and as such, can’t establish cause. The researchers also point to some limitations, such as being unable to identify type of heart failure, and the possibility that some data may have been incomplete or misclassified.

Nevertheless, they say survival after a diagnosis of heart failure “has shown only modest improvement in the 21st century and lags behind other serious conditions, such as cancer.”

The researchers add that new strategies “to achieve timely diagnosis and treatment initiation in primary care for all socio-economic groups should be a priority for future research and policy.”

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