Ottawa Citizen

Heart failure rates set to skyrocket: cardiologi­st

- BY PAMELA FAYERMAN

VANCOUVER • Canada is in the midst of a heart failure epidemic that will only get worse because of aging baby boomers and more people surviving heart attacks with damaged hearts, delegates to the Canadian Cardiovasc­ular Congress were told yesterday.

Dr. Malcolm Arnold, a London, Ont., cardiologi­st who heads a national task force on newly released diagnosis and treatment guidelines, said in an interview that an estimated 400,000 Canadians have heart failure and about 25 per cent of them go to hospital each year with abnormal heart function symptoms like lightheade­dness, swollen legs and feet, breathless­ness and fatigue.

Heart failure is the most common diagnosis in people over age 65 and hospitaliz­ations ( 13 days, on average) because of it are projected to at least double in the next 20 years.

Heart failure is said to be the only type of serious heart disease that’s steadily increased over the past five to 10 years. To help stem the increase in hospitaliz­ations, the Canadian Cardiovasc­ular Society is asking family doctors to bone up on heart failure knowledge so they don’t waste any time getting patients diagnosed and treated.

Dr. Beth Abramsom, a cardiologi­st who is spokeswoma­n for the Heart and Stroke Founda- tion, said heart failure is the ironic “ price we are paying for our success in treating other forms of heart disease.

“ This is the only form of heart disease that is growing. Patients with cardiac conditions are living much longer, but the result is that they become more vulnerable to heart failure,” said Dr. Abramsom.

Dr. Arnold said it’s called heart failure because it is such a serious diagnosis, which reflects what is happening to the heart. Up to 50 per cent of all people die within five years after the diagnosis, a risk of death he called greater than that from most cancers. But medication­s can help improve quality of life and manage the underlying risk factors, which can include high blood pressure, diabetes and high cholestero­l. Clinical studies have shown that medica- tions can reduce the risk of dying by up to a third in the next five years after a diagnosis.

Dr. Arnold said there is no way of knowing how many Canadians get a delayed diagnosis, but often their complaints are brushed off as part of aging. “ We’re asking family doctors to have a high index of suspicion when patients complain of these symptoms and order the diagnostic tests outlined in the guidelines we are sending them,” he said, referring to a laminated pocket- sized pamphlet that provides informatio­n about symptoms, risk factors and diagnostic tests to order.

Family doctors are also given informatio­n about how often to follow such patients, what to do at each visit and when to refer patients to specialist­s.

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