Study exposes extra risk for heart patients

About three in 10 New Zealanders admitted to hospital with heart failure for the first time die within a year. Photo / Richard Robinson

Many people with heart failure are not getting effective treatment and so face an increased risk of dying, an international study led by University of Auckland researchers has found.

About three in 10 New Zealanders admitted to hospital with heart failure for the first time die within a year.

The study has found standard drug treatments do not work on about a quarter of the patients.

The researchers, who used data from more than 45,000 patients involved in 29 international studies, say their findings should lead to improvements in the care of heart failure patients - and the Ministry of Health agrees.

"Most people have heart failure because their heart muscle does not pump blood properly," said the lead researcher, Associate Professor Rob Doughty of the University of Auckland.

"For these patients, the standard heart failure treatment, which is designed to improve pump function, can be very effective.

"But our research has shown that about one in four patients have normal heart pump function. Their heart failure is caused instead by stiffening of the heart muscle, and for these people, standard treatments targeting heart pump function will not be of benefit."

Standard treatment usually included diuretics to relieve congestion in the heart and drugs to treat constriction.

Previous research suggested that all patients with heart failure had a similar outlook, regardless of whether their symptoms were due primarily to pump failure or stiff heart muscle, Professor Doughty said.

"Because of this, doctors have assumed that all patients should be treated in the same way. Our research has shown that this is not correct."

Patients whose condition was not well managed had an increased risk of death, a lower quality of life and had to return repeatedly to hospital.

"Our findings have important implications for patients as they deal with this chronic illness, and for the physicians and nurses who help them," Professor Doughty said.

"By gaining a better understanding of the underlying causes of the disease, we will eventually be able to develop more effective treatments that will improve patient health and survival as well as reducing healthcare costs."

Ministry of Health chief adviser Dr Sandy Dawson said the study was an outstanding piece of research.

"These research findings will be valuable to clinicians and will lead to improvements in the care of patients with heart failure."

The Heart Foundation said the study had drawn worldwide attention.

Its medical director, Professor Norman Sharpe, said: "The findings ... should lead to direct improvements in the care of patients with heart failure, which is a common but complex and difficult condition to manage."