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Friday, 10 August, 2001, 09:38 GMT 10:38 UK
GPs 'not spotting' heart failure
Heart failure causes excessive breathlessness and fatigue
Heart failure causes excessive breathlessness and fatigue
Patients with heart failure are being missed by GPs, scientists say.

Their new research, published in the Lancet medical journal, suggests that the condition is far more common than many doctors believe.

This means that family doctors may be missing hundreds of cases.

Heart failure happens when heart becomes progressively less efficient at pumping blood around the body.

The patient gradually feels more and more tired with common symptoms including breathlessness and severe water retention.

It can be treated, but there is no accurate data available to show how prevalent the various causes of heart failure are.

But statistics from one hospital showed 4.9% of admissions were for heart failure, which would mean 120,000 admissions across the UK each year, if that rate was reflected across the country.

Checks

Researchers from the University of Birmingham assessed 3,960 randomly-selected patients, all 45 or older, from 16 GP practices.


Prevalence rates indicate that heart failure is a major burden of disease in the United Kingdom

Professor Richard Hobbs,
University of Birmingham
They asked about patients' medical history and carried out checks on their hearts, such as an electrocardiograph (ECG) and echocardiography, an ultrasound of the heart.

They were checked for heart failure, including a kind called left-ventricular systolic dysfunction (LVSD).

LVSD was seen in 72 patients, 34 of whom had no symptoms.

There were 139 patients whose left heart function was classed as "borderline".

Ninety-two had definite heart failure - 38 with LVSD, atrial fibrillation in 30 and heart-valve disease.

A further 32 had probable heart failure.

Previous studies have looked at the prevalence of LVSD.

But writing in the Lancet, the researchers said they also checked for atrial fibrillation, a type of irregular heartbeat and heart disease where the valves are damaged - two other major causes of heart failure.

Screening

Professor Richard Hobbs, who led the research, said: "Prevalence rates indicate that heart failure is a major burden of disease in the United Kingdom.

"Accurate identification of all patients with heart failure is important, since treatments are available that can alleviate symptoms, delay progression of the disorder, and improve prognosis."

In an editorial in the Lancet, Mark Petrie and John McMurray from the Clinical Research Institute in Heart Failure at the University of Glasgow highlight the Birmingham research's findings that most people with symptomless LVSD have a history of other cardiovascular disease.

"The cost-effectiveness of screening for and treating symptomless LVSD requires evaluation," they wrote.

The British Heart Foundation said an estimated 760,000 people in the UK had heart failure.

A spokeswoman said: "Eventually it will be much easier to estimate the number of people with this condition, as the recent National Service Framework for coronary heart disease demands improved data collection from GPs.

"This will help in the planning of new national services for patients with this condition."

See also:

06 Mar 01 | Health
Heart failure damage reversed
18 Oct 00 | Health
Test for heart failure
20 Sep 00 | Health
Doctors 'reverse' heart failure
23 Jun 00 | G-I
Heart failure
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