What we have most to fear is failure of the heart.

Justine Cadet, News Editor

While feminist activist and writer Sonia Johnson was not referring to the physiologic cardiac condition that impairs the heart’s ability to supply sufficient blood flow, much discussion at this year’s AHA conference illuminated the unsuccessful attempts of the cardiovascular community (and the press) to properly address the widespread dangers of heart failure with providers and the public.

Despite the clinical flurry that surrounded heart failure at the AHA meeting, the disease was relatively overshadowed when compared to the highly-anticipated and much-publicized world of statins and stents.

Yet, the disease looms as a constantly growing problem, and the gap between the clinical understanding and provider-patient knowledge remains cavernous. The experts lamented over this gap, yet noted that it may be further complicated because the disease is still an enigma to many physicians.

Dr. Barry M. Massie, co-principal investigator of the I-PRESERVE, said that heart failure is “not a big business, and therefore it’s not on ER,” so many people have misconceptions about the condition. “Most people think that heart failure means that one’s heart actually stops, and we have not found a good way to communicate about the life-threatening disease.”

A few other physicians on the panel with Massie questioned whether the age of heart failure patients, which tends to be about ten years older than an average MI patient, affects the dissemination of the data. And yet, it is quite crippling within that population, affecting 6 to 10 percent of people over the age of 65, according to Dr. Christopher M. O’Connor from Duke University. “In that subgroup, it is more important than almost any other disease. The problem is that we’ve been at a loss for how to educate people about heart failure for decades,” O’Connor said.

More than five million Americans are living with the condition, and 550,000 new cases are diagnosed each year. Dr. Margaret M. Redfield from the Mayo Clinic said that heart failure is the most common reason for hospitalization in people over the age of 65, so “we’ll have to start dealing with this problem more effectively, as we try to get healthcare costs under control.”

One study found that the typical inpatient costs for a severe heart failure patient is about $24,000 annually compared to about $3,000 for a typical Medicare beneficiary.

The good news is that its lack of popularity has not halted the clinical investigations. “There have been breakthroughs, and we now have a wonderful collection of evidence-based strategies and that literature is building, but we need to do a better job communicating the evidence,” according to Dr. Clyde W. Yancy, the incoming president-elect (08-09) of the AHA’s national board of directors.

So, maybe our ignorance to the nuances of heart failure reflects a failure of different kind.

On these topics, or any others, feel free to contact me.

Justine Cadet, News Editor
jcadet@cardiovascularbusiness.com