Heart failure: More or less malignant than cancer?

August 31, 2009

A recently completed analysis of over one million hospital cases in Sweden during the period 1988 to 2004 has revealed that heart failure, relative to most common forms of cancer specific to men and women, represents a major health burden in respect to the risk of being hospitalised for the first time, poor overall survival and the number of premature life-years lost.

Heart failure is a debilitating and deadly syndrome that commonly occurs in those who have suffered high blood pressure over a long period of time and/or suffered a heart attack. As the term suggests, heart failure means that the heart is permanently damaged leading those who are affected to experience debilitating symptoms and remain at high risk of being hospitalised and/or suffer a premature death.

It has long been known among cardiovascular experts that heart failure is a major health problem for both men and women in many developed countries. However, the risk of being hospitalised and dying from heart failure (and other forms of heart disease) has been largely under-estimated by the general public and health authorities in comparison to more "high profile" conditions such as the common forms of cancer (e.g. prostate cancer in men and breast cancer in women).

A team of researchers from Australia (Professor Simon Stewart) and Sweden (led by Professor Annika Rosengren) examined the pattern of hospital admission and subsequent outcomes in 1,162,309 patients in Sweden during the period 1988 to 2004, to determine the population impact of heart failure compared to the most forms of cancer.

More cases of heart failure than common cancers combined.

Key findings of this study show that the annual rate of a first-ever hospital for heart failure, acute heart attack and the most cancers in men (lung, colorectal, prostate and bladder cancer combined) and women (lung, colorectal, bladder, breast and ovarian cancer combined) in Sweden during the period 1988 to 2004 were as follows:

• 484, 424 and 373 cases per 100,000 men aged 20 years or more
  
• 470, 280 and 350 cases per 100,000 women aged 20 years or more

The ratio of heart failure to cancer cases overall was 1.5: 1 (321,951 vs. 224,091 cases).

More heart failure-related deaths than the common cancers combined

Despite improvements in 30-day and 5-year survival rates over the study period, heart failure was still associated with poor survival rates - 59% of patients died within 5 years of their first hospital admission.

Overall, heart failure was associated with more deaths than the most common forms of cancer combined:
196,400 vs.131,000 deaths.

More premature life-years lost due to heart failure in men

Over a ten year period, heart failure was associated with more premature life-years lost (i.e. dying before average life-expectancy) than the most common forms of cancer in men.

• 66,318 life-years lost due to heart failure vs. 55,364 life-years lost due to cancer
  
• Estimated cost of heart failure due to loss of life and quality of life combined equal to 16.4 billion SEK vs. 5.3 billion and 4.1 billion SEK for lung and prostate cancer, respectively

A similar number of premature life-years lost due to heart failure in women

Over a ten year period, heart failure was associated with slightly less premature life-years lost than the most common forms of cancer in women:

• 59,353 life-years lost due to heart failure vs. 69,533 life-years lost due to cancer
  
• Estimated cost of heart failure due to loss of life and quality of life combined equal to 13.8 billion SEK vs. 4.2 billion and 2.2 billion SEK for breast and ovarian cancer, respectively.

Professor Simon Stewart from Baker IDI Heart and Diabetes Institute in Australia says that these findings highlight the enormous and often under-estimated impact of heart failure in Sweden and beyond.

"These data show that for both men and women, the risk of being hospitalised and dying from heart failure is often as great as that posed by the more commonly 'feared' cancers."

"Hopefully, these findings will alter the public perception of heart failure as a major public health problem that requires an appropriate response both at the individual (e.g. regularly exercising and eating well) and government level (e.g. investing in more research and proven health care resources)."

Source: European Society of Cardiology (news : web)