Researchers detail trends of increasing heart failure across UK

The number of new people diagnosed with heart failure each year in the United Kingdom is now similar to that of the most four common types of cancer combined, according to the most comprehensive review of heart failure statistics in the U.K. to date, published online Nov. 21 in The Lancet.

Senior study author Kazem Rahimi, DM, MSc, and colleagues studied electronic health records (EHRs) of more than 3.9 million patients, a nationally representative sample.

Heart failure incidence by age and sex in the U.K. declined by 7 percent from 2002 to 2014, the researchers found, but the estimated number of individuals with newly diagnosed heart failure grew by 12 percent because of population growth and aging.

Overall, the estimated number of prevalent heart failure cases grew by 23 percent, from 750,127 to 920,616.

“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,” Rahimi said in a press release. “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.”

Among the other findings from the study:

• The average age of people with heart failure increased from 76.5 to 77 years old, with an 8 percent increase in the rate of people 85 or older developing heart failure. However, the proportion of new cases decreased across most other age groups.
• The number of other chronic conditions in patients increased from 3.4 in 2002 to 5.4 in 2014. Rahimi et al. pointed out this makes treatment of heart failure more complex, further burdening health services.
• People from the most deprived socioeconomic backgrounds were 61 percent more likely to develop heart failure than patients from the most affluent backgrounds. Patients from deprived backgrounds were an average of 3.3 years younger at diagnosis (74.5 vs. 77.8 years old). Notably, the gap increased over time, with the most deprived patients being diagnosed nearly a half-year earlier in 2014 than 2002 and the most affluent patients being diagnosed approximately 2.5 years later at the end of the study.

The researchers estimated the number of annual heart failure cases could be reduced by 31,810 if these socioeconomic disparities were removed.

“The profile of patients with heart failure is diverse and evolving over time—with a trend towards older age and a substantial increase in the number of associated comorbidities—indicating that both prevention and management are becoming more complex,” the authors wrote. “The observed disparities in heart failure incidence by sex, socioeconomic status, and region point to potential opportunities for more targeted and equitable prevention strategies.”

Rahimi et al. said their findings may be applicable to other developed countries with aging populations.

Limitations of the study include incomplete medical data—which made it impossible to determine the type of heart failure for patients—and the reliance on accurate coding by physicians for the EHRs.

In a related editorial, Faiez Zannad, MD, PhD, described the authors’ comparison of heart failure to cancer as “compelling.”

“Despite their similar epidemiology, and worse survival for patients with heart failure compared with many forms of cancer, there is a continued disparity between the diseases in terms of research investment, focused prevention, and societal awareness,” Zannad wrote. “Perhaps these data will stimulate change and encourage heart failure to be addressed as an equal priority with cancer.”