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Heart Failure: An Overview from the British Society for Heart Failure (BSH)

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Simon Williams

Chair Elect, British Society for Heart Failure

Consultant Cardiologist & Honorary Senior Lecturer, Wythenshawe Hospital, Manchester

Most people have heard of heart failure, but it is frequently misunderstood and often confused with a heart attack, a cardiac arrest or other heart disease.

Heart failure is the inability of the heart to pump blood around the body. This leads to symptoms of breathlessness (either on exertion or at rest), extreme tiredness and swollen feet and legs.

Common causes are ischaemic heart disease, myocardial infarction (heart attack) and hypertension (high blood pressure).

Despite the prevalence being similar to the four commonest cancers combined, it doesn’t get the recognition or funding it deserves. Heart failure costs the NHS £2.3 billion a year (2% of the total budget).

Heart failure is a modern day epidemic

Heart failure affects around 920,000 people in the UK, with this number is likely to rise due to an ageing population, more effective treatments, and improved survival rates after a heart attack.

Over the past 30 years there have been huge advances in available treatments. Many people with heart failure now live a normal life providing they have the right support from their specialist healthcare team.

There are almost 200,000 new cases diagnosed each year, with the number increasing year on year. However, a lack of understanding about the condition and the lack of awareness of heart failure symptoms can delay early diagnosis and referral to a specialist team, which can lead to a delay in effective treatments being given.

Heart failure affects around 920,000 people in the UK, with this number is likely to rise due to an ageing population.

Many people with heart failure are not receiving adequate care following diagnosis and there is considerable national variation in the level of service provision.

Heart failure is a large burden on the NHS: It accounts for one million bed days per year and 5% of all emergency admissions to hospital. Improving heart failure service provision can prevent costly re-admissions and provide efficiencies in the NHS.

We can do more

We have made astonishing progress in the fight against heart failure and are winning, but we could do even better and bring more hope to heart failure patients and their carers.

By increasing public awareness of the signs and symptoms of heart failure, an early diagnosis can be made in primary care with a simple blood test called Brain Natriuretic Peptide (NT-pro BNP).

Suspected cases can be quickly referred to a specialist heart failure team who can confirm the diagnosis and offer early treatment with effective therapies. With these therapies, we have seen prognosis improve considerably over the past 10 years. However, we need to do more.

Be aware of the symptoms. If you think you have them, talk to your GP. Ask for the NT-pro BNP blood test. It is time to act fast. Early diagnosis leads to quicker referral to a specialist team and treatment with life-saving therapies.

Fighting heart failure with public support

The British Society for Heart Failure needs the support of the public, patients and policy makers to support health care professionals to build on these green shoots of success to ensure all heart failure patients, no matter where they live in the UK, receive equitable access to specialist heart failure care.


References:Temporal trends an patterns in heart failure incidence: a population-based study of 4 million individuals. Conrad et al. Lancet 2018;391:572-90 | Chronic heart failure in adults: diagnosis and management. www.nice.org.uk/guidance/ng106 | National heart failure Audit. www.nicor.org.uk/wp-content/uploads/2018/11/Heart-Failure-Summary-Report-2016-17.pdf

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