Making heart failure a global health priority to transform patient care

As a cardiologist, I’ve seen first-hand the devastating impact of cardiovascular disease, including heart failure, and I’ve been privileged to help thousands of people manage their health issues during my time in clinical practice. Heart failure affects approximately 64 million people around the globe, reducing their quality of life and with a death rate of around 50% within five years of diagnosis, a prognosis much worse than many cancers.^1,3-7 The good news, however, is that the treatment landscape is evolving and offers new hope for earlier detection and better disease management.

Heart failure is a complex disease affecting tens of millions of people around the world^{1 -3}

Heart failure is often complicated by multiple interrelated conditions, so it requires a deep understanding of the potential disease drivers for every individual heart.^8,9 Current heart failure treatments broadly follow a “one-size-fits-all” approach.¹⁰ However, due to the wide range of mechanisms by which heart failure can occur, one size does not fit all – treatment should be tailored to the individual. That’s why at AstraZeneca we are dedicated to uncovering the underlying biology of heart failure to identify novel disease drivers.

Heart failure puts increasing economic pressure on healthcare systems^11,12

Heart failure not only impacts patients and their caregivers, but also places an immense strain on healthcare systems around the world. The annual global burden of heart failure is $346 billion USD and is projected to increase by 127% by 2030.^13,14 It is the leading cause of hospitalisations in people aged 65 and over and has the highest 30-day readmission rate among all medical conditions.¹⁵ This is why we’re calling on policymakers to make heart failure a global health priority.

Patients with suspected heart failure have an immediate and very high risk of adverse outcomes, including hospitalisation and death.¹⁶ There is therefore an urgent need to implement effective policy strategies to reduce hospitalisations and improve patient outcomes through earlier intervention in heart failure. And efforts are underway to do just that. The Heart Failure Policy Network recently hosted its annual Hearth Failure Policy Summit, which brought together leaders from policy, academia, patient advocacy and clinical settings to discuss the latest national and international advances in heart failure care and policy change. The insights generated by the Summit’s featured online sessions highlight the road to political commitment.

While improving heart failure patient outcomes through early symptom recognition and effective approaches to diagnosis rose to the top as a key area of focus, there are other opportunities to drive change. Scientific advances have led to the use of therapies that can delay disease progression, significantly improving patient outcomes, but further innovation is needed to tackle the underlying causes of disease.

Research helps classify heart failure patients by disease drivers, not symptoms

Proper heart failure diagnosis, care and treatment requires a deep understanding of the wide range of potential disease drivers, and the complications that can arise from other interconnected conditions.¹⁷

We now know heart failure has several stages and types and can be a result of a collection of different diseases.8,^9,18 Heart failure can be hard to define and treat in routine clinical practice.¹⁹ There are several types of heart failure, including heart failure with reduced ejection fraction (HFrEF), which can occur after a heart attack, causing the loss of over a billion heart muscle cells.^10,20-22 This impairs the pumping capacity of the heart, which does not contract properly to expel oxygen-rich blood to the body.^10,21 In heart failure with preserved ejection fraction (HFpEF), the heart muscle contracts normally but inadequate filling of the heart is caused by stiffening of the muscle often related to inflammation, fibrosis and microvascular dysfunction, or deposition of abnormal protein as found in amyloid cardiomyopathy.^23,24 In recent decades an increasing proportion of people with heart failure have HFpEF – approximately 50%.^25,26  

Understanding the different types of heart failure is critical to identifying what is driving the disease. For example, a possible underlying cause of HFpEF is a lesser-known condition called transthyretin amyloid cardiomyopathy (ATTR-CM), which is fatal if left untreated.^24,27  ATTR-CM accounts for up to 15% of people with HFpEF.^28,29 ​Often this specific diagnosis is missed, or only made after visits to several doctors over many months.^30,31 This needs to change as there are treatment options available and more innovations on the horizon. ATTR-CM is just one example of why when people present with symptoms that may be due to heart failure, it is vital to make the correct diagnosis and to work out the underlying causes of the failure. Only with a correct and full diagnostic work-up can a targeted treatment plan be constructed to improve the outcome for that individual patient.  

Science advances our understanding of CVRM diseases and our ability to innovate

At AstraZeneca, we’re committed to diving deep into the root cause of heart failure to determine the changes we need to make in ways we treat this disease, transform care and ultimately improve outcomes. By harnessing the power of next generation therapeutics and digital innovations we aim to halt disease progression, protect vital organs and, ultimately, pave the way to a cure for heart failure.

The heart failure landscape has changed greatly since I first entered the medical profession more than 30 years ago, and there is the promise of more scientific advances ahead. This, when coupled with effective policy change to prioritise timely detection and management of heart failure, will make the outlook brighter for the millions of people around the world affected by this condition. 

Veeva ID: Z4-64187
Date of preparation: May 2024