Global Alliance on Heart Failure & Healthy Aging Launches Best Practices Report on Heart Failure Detection, Diagnosis, Treatment and Care

The report highlights the importance of better detection and earlier diagnosis, a life-course and multidisciplinary management approach to heart failure (HF), and care-delivery models that are suited to older adults.

Today, the Global Alliance on Heart Failure and Healthy Aging, convened by the Global Coalition on Aging (GCOA), is launching the report “Tackling Heart Failure As We Age: Best Practices in Heart Failure Detection, Diagnosis, Treatment and Care.” The paper demonstrates that heart failure is not a normal part of the aging process but in fact can be more effectively detected and diagnosed to ensure better treatment and management of HF. By offering a clear set of success factors to improve prevention and care for heart failure and highlighting case studies from the United States and Europe, the report aims to reduce the ageism associated with HF and therefore improve the lives of those with and at risk of HF.

Even before the COVID-19 pandemic hit, progress in heart failure care was stalled. Survival after a diagnosis of heart failure has only modestly improved in the 21st century and lags behind other serious conditions” said Michael W. Hodin, PhD, CEO of GCOA. “It’s time to rethink the way our health systems detect, diagnose, treat and care for people with heart failure. A place to start with this re-thinking is how ageism adversely shapes how we approach older people with symptoms that results in delayed or non-diagnosis too often until it’s too late.”

More people die annually from cardiovascular disease than from any other cause. As populations age, urbanization spreads, and the control of infectious and childhood diseases improves, cardiovascular disease (CVD) prominence rises alongside things like high-fat diets, smoking, and sedentary lifestyles. The increase in CVD deaths during the current COVID-19 pandemic, because of the increased risk of contracting COVID-19 or because of the lack of or hesitation to seeking medical care, points to questions about optimal treatment and care.

The report underlines the inadequacies of today’s health systems to deal with heart failure as the population of older adults keeps growing. It identifies four best practice areas to help improve HF diagnosis and care, and therefore the lives of patients living with HF and overall health system costs.

  • Early heart failure detection and diagnosis efforts must be enhanced.
  • Patient must be empowered through a life-course approach to prevention, detection, and management of heart failure.
  • Multidisciplinary care teams led by clinicians with specialized training in cardiology can meet the varied and changing needs of people with heart failure and their families and can help to ensure seamless transitions and closely coordinated treatment efforts.
  • Health systems should embrace innovative care-delivery models suited to older patients.

As heart failure affects at least 26 million people around the world, it is notably one of the few cardiovascular conditions that is increasing in prevalence—the total cost of heart failure is predicted to increase 127% by 2030. Lending urgency to the challenge, the World Heart Federation’s heart failure roadmap estimates that there are 11.7 million cases of undiagnosed heart failure globally.

“Mortality linked to heart failure remains high, with 45-60% of people dying within the five years following a first admission to the hospital. This results in increased costs for healthcare systems, and most importantly in lower quality of life for patients and huge emotional burden for families” highlights Jean-Luc Eiselé, CEO, World Heart Federation and member of the Alliance’s Governing Board.

As the global population over 60 is predicted to double by mid-century, reaching 2 billion, it is more urgent than ever for health systems to rethink their response to heart failure.

To learn more about these key areas for action, you can access the report by clicking here.

To learn more about GCOA’s work to highlight innovative approaches to heart failure diagnosis and care as we age, check GCOA’s cross-sectoral session on heart failure, data, digital solutions and patient empowerment that took place during the World Summit of Information Society (WSIS) Forum 2020. The session was part of the first-ever “information and communication technologies and older persons” track at WSIS.

As Heart Valve Disease Awareness Week Gets Underway, Croí Urges Government to Offer Free Annual Cardiac Check for Over 55s

Survey of 1,000 People Over 60 Years Finds Low Awareness of Heart Valve Disease, its Symptoms & the Need for Stethoscope Checks

The European Heart Health Survey, an international survey of people over 60 years across 11 European countries, has found very low awareness in Ireland of heart valve disease and of certain symptoms requiring medical attention. Heart valve disease is largely a condition of ageing and, when it comes to a simple stethoscope check that can diagnose it, one in five respondents say that they either never have a stethoscope check or only have one when they ask their GP for it.

Croí, the heart and stroke charity, is calling for Government to offer everyone over 55 years a free annual cardiac check to ensure early diagnosis of a range of cardiovascular diseases. The call comes as International Heart Valve Disease Awareness Week gets underway from September 14-20. The week is an initiative of the Global Heart Hub, an international alliance of heart patient organisations from around the world, and is led in Ireland by Croí.

Rising Numbers

Heart valve disease is where one or more of the valves in the heart is diseased or damaged, giving rise to a narrowing of the valve (stenosis) or causing leakage (regurgitation), meaning the heart can’t pump blood effectively.

For too many people, symptoms are either not recognised or ignored and this can have fatal consequences. People perhaps recognise more overt symptoms such as chest pain and irregular heartbeat, but more understated symptoms such as breathlessness and tiredness, can be important red flags as well.

Estimates suggest that 13% of people over 75 years will experience heart valve disease. There are over 2.7 million people across Europe age 65 and over thought to have heart valve disease with this figure set to rise to 20 million Europeans within the next two decades due to changing age demographics.

If severe aortic stenosis is left untreated – the most common form of heart valve disease – 50% of patients will die within two years of developing symptoms. While common and serious, heart valve disease is very treatable.

Survey Highlights

The European Heart Health Survey by Censuswide questioned 1,000 people over 60 years in Ireland and found:

  • Awareness: only 5% of respondents could accurately define aortic stenosis, the most prevalent type of heart valve disease – 95% could not. This compares with 12% in the Netherlands who could accurately define the condition
  • Diagnosis: only a third (32%) claim to receive a stethoscope check that can detect a heart murmur at every GP visit – compared with 76% in France and 57% in Belgium. One in ten (9%) say they never receive a stethoscope check from their GP and a similar number (10%) only when they ask for one
  • Symptoms: while the majority of respondents would seek an appointment with a general practitioner for symptoms such as chest tightness/pain (87%), shortness of breath (68%), abnormal heartbeats (67%) or feeling faint (51%), only a minority would seek medical help if they had some of the other key symptoms of aortic stenosis, such as fatigue (30%), reduced physical activity (21%) and feeling older than your age (18%)
  • Treatment: those surveyed would prefer a keyhole procedure (69%) over open-heart surgery (5%), or daily/weekly drug therapy for the treatment of a heart condition (24%)
  • Economy: respondents are key contributors to the economy, playing an important role as carers with almost a third (28%) providing care for someone close to them
  • Community: more than four fifths (87%) regularly participate in activities, including sports (56%), volunteering for a charity or community (31%), and social activities with their peers (26%)

Benefits are Clear

For Neil Johnson, CEO, Croí, the provision of a free annual cardiac check for the over 55s would have clear health and economic benefits:
“Heart valve disease is predominantly an age-related condition. As we get older, the greater the chances of developing it. Early detection and timely treatment not only reduce the impact of the disease but increase longevity with enhanced quality of life.

“Globally we are living longer and it’s in everyone’s interest that we maintain good health and quality of life for as long as possible. A stethoscope check is an inexpensive means of undertaking early diagnosis for heart valve disease and everyone over 65 years should have one at least once a year.

“This combined with checks for other cardiovascular diseases such as a pulse check for atrial fibrillation, blood tests for heart failure and cholesterol, and blood pressure checks for heart attack and stroke, should form part of a comprehensive annual cardiac check.

“This International Heart Valve Disease Awareness Week, we are calling on Government to provide a national free annual cardiac check for everyone over the age of 55. These are simple, inexpensive and non-invasive tests, and the many benefits of implementing such an initiative are clearly evident.”

For Prof. Dr. Helge Möllmann, Klinik für Innere Medizin I, St.-Johannes-Hospital, Dortmund, and lead author of the survey, it is important that older people know about the disease and the symptoms to look out for:

“The senior population are a group at risk, more so as they grow older, so it is important that they are more aware of the disease and understand the severity of often hidden symptoms to help ensure early diagnosis and timely treatment. It is estimated by the age of 75, the prevalence of heart valve disease is 13%. More work needs to be done to shift the awareness level and that is why this week, Heart Valve Disease Awareness Week, is a key step for improved patient outcomes.”

Full information on the week can be found at www.croi.ie/valveweek.