Four in five heart disease patients may be being denied life-saving treatment, study finds


Up to four in five Britons suffering from a deadly heart condition might be being denied life-saving treatment, a study has found.

The research suggests thousands of lives could be being needlessly cut short, because of widespread failures across the NHS to adhere to standard cardiac advice.

The UK study of 15,000 heart failure patients found the vast majority were not receiving cheap pills at doses that have been proven to reduce hospitalisations and improve survival.

One in five people will develop heart failure within their lifetime and it carries a high risk of early death.

More than half a million people are estimated to suffer from the condition, which is the leading cause of hospital admissions for over-65s.

It occurs when the heart has become too weak and is unable to pump blood around the body properly, often following a heart attack.

International heart failure guidelines outline the type and dose of therapy that patients with the most common type of heart failure should receive.

The two-year study examined whether or not patients with heart failure in the UK actually receive these treatments.

Just 20 per cent of cases were found to be getting the right mix of medications at the right doses, the research led by Glasgow University found.

Experts raised fears that some doctors were wrongly assuming that elderly people would not be able to tolerate the drugs, despite evidence to the contrary.

Investigators assessed rates and causes of hospitalisation, rates of serious illnesses and deaths, and treatment practices from 2009 to 2011. 

Around 86 per cent of elderly patients were alive after a year. Researchers were unable to calculate how many extra lives would have been saved, if the right therapy had been given, but the drugs have been shown to improve survival rates by up to 25 per cent.

Presenting the findings at the European Society of Cardiology Congress in Rome, lead author Dr Pardeep Jhund, a cardiologist at the University of Glasgow, said: Our results highlight that rates of hospital admissions and deaths in patients with heart failure remain substantial. 

Evidence-based, guideline-recommended therapies are under-used, and used at lower doses than those shown to be effective. Prescription rates of therapies must increase, and therapies must be prescribed at higher doses, to reduce hospitalisations and help these patients live longer.

Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said: This research demonstrates that doctors may not have been as astute as they should have in providing the most up-to-date evidence-based therapies, leading to some heart failure patients not be being optimally treated.

He said some doctors might not be up-to-date with current medicine, and wrongly think that older patients would not benefit from the drugs.

Some clinicians may feel that some elderly and extremely sick patients will not be able to benefit from additional medication, which may be true, however the recommended treatments should be considered in every case, he said. 

Under European cardiac guidelines, patients suffering from heart failure are supposed to be given a combination of drugs, each of which costs pennies.

The research, which was funded by drugs company Novartis, used GP records to track of 14,546 heart failure patients, who had an average age of 79.

The team found that just 57 per cent of patients were prescribed a beta-blocker – which costs as little as 3p a tablet and reduces stress on the heart – and 31 per cent were given a mineralocorticoid receptor antagonist, which costs 6p a pill.

Only 80 per cent were given an ACE inhibitor, at 3p a tablet, or an ARB angiotensin receptor blocker, at 28p a pill – and of these most were given the wrong dose.

In total, just 20 per cent of patients were getting all of the medications they should have been on, at the right doses.

These findings emphasise the need to treat patients with heart failure using evidence-based, recommended therapies at doses that have been shown to be effective in clinical trials, said Dr Jhund.

This is vitally important considering the high costs of hospitalisation and poor life expectancy associated with this condition.

News Source TelegraphNews

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