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

29 August 2016  |  Editor

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

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One in five people will develop heart failure within their lifetime.

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

The research, which tracked 15,000 UK heart failure patients for two years, suggests thousands of lives could be being shortened because of NHS failures to adhere to cardiac guidelines.

One in five people will develop heart failure – the term used when the heart becomes less effective at pumping blood around the body – within their lifetime, and it carries a high risk of early death. 

“Prescription rates of therapies must increase, and therapies must be prescribed at higher doses, to reduce hospitalisations and help these patients live longer," says ”Dr Pardeep Jhund.

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

Under European guidelines, patients suffering from heart failure are supposed to be given a combination of drugs, costing pennies per pill, which used correctly have been shown to improve survival rates by up to a quarter.

However, just 20 per cent of cases appeared to be receiving the right mix of medications at the right doses, the 2009 to 2011 study led by University of Glasgow found. 

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. 

New appeal to look out for symptoms of lung and heart disease.

“Evidence-based, guideline-recommended therapies are underused, 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.” 

The research, funded by drugmaker Novartis, 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.

At a glance | Heart disease

Coronary heart disease (CHD) is caused by the build-up of fatty substances on the walls of the arteries around the heart. The build-up of these fatty deposits make the arteries narrower, restricting the flow of blood to the heart. This process is called atherosclerosis.

This can be caused by a number of lifestyle factors and conditions, including smoking, high cholesterol, high blood pressure and diabetes. Other risk factors include obesity and family history of CHD.

Symptoms can include:

  • Chest pain - this can be a mild, uncomfortable feeling similar to indigestion.
  • If the arteries become completely blocked by a build-up of fat it can cause a heart attack
  • Heart palpitations
  • Unusual breathlessness

Treating heart disease:

There is no cure for heart disease but treatment can help manage the symptoms and reduce the risk of any further problems. The main treatments are:

  • Lifestyle changes - more exercise, healthy eating and stopping smoking can help prevent further effects of CHD.
  • Medicines - they aim to reduce blood pressure and to widen arteries, these include beta-blockers, nitrates and calcium channel blockers.
  • Surgery - If symptoms cannot be controlled by lifestyle changes or medication there are surgical procedures to open up or bypass blocked arteries.

Source: NHS

Prof Jeremy Pearson, the associate medical director at the British Heart Foundation, said: “This 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, and wrongly think that older patients would not benefit from the drugs, when in fact the medication should be considered case by case.