Survival after a diagnosis of heart failure in the United Kingdom has shown only modest improvement in the 21st century and lags behind other serious conditions, such as cancer, finds a study carried out by the Universities of Birmingham and Oxford.
The findings, published in The BMJ, also show that survival is worse for people requiring admission to hospital around the time of diagnosis, and for those in the most deprived groups.
The researchers, funded by the National Institute for Health Research (NIHR), said that unlike cancer, heart failure has not been a priority for government policy or funding and their results should alert policy makers to the need for further investment in heart failure services.
Professor Tom Marshall, of the University of Birmingham’s Institute of Applied Health Research, said: “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 lack of substantial progress in improving heart failure survival rates should alert policy makers to the need for further investment in heart failure services.
“New strategies to achieve timely diagnosis and treatment initiation in primary care for all socioeconomic groups should be a priority for future research and policy.”
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.
A 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 socioeconomic group.
Using UK primary care data from 2000 to 2017 linked to hospital and mortality records, they 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.
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.
They also found an average 2.4 year difference in survival (11.1 v 8.7 years) for people who were least deprived compared with the most deprived group.
For more information or to arrange interviews with Prof Coleman please contact Emma McKinney, Communications Manager (Health Science), University of Birmingham: +44 (0)121 414 6681.
- Taylor et al (2019). ‘Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study’. The BMJ. DOI: 10.1136/bmj.l223
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