NHS faces ‘ticking bomb’ with number of heart failure patients set to soar

The health service faces a “ticking time bomb” over people suffering from heart failure, with diagnosed cases predicted to nearly double by 2040, medical experts have warned.

The British Society for Heart Failure (BSH) warns there are an estimated 400,000 people with undiagnosed heart failure in the UK. It warns there is an urgent need for a national initiative to detect these cases or NHS services face being overwhelmed in future years.

Heart failure happens when the heart is unable to properly pump blood around the body. It is a long-term condition that cannot be cured, but early diagnosis and treatment can reduce the risk of hospitalisation and death. Treatments include medication to improve heart function and surgery, implanting a pacemaker to control heart rate or heart surgery to improve blood flow.

About 80% of patients with heart failure are diagnosed after emergency admission to hospital. About one in 10 die in hospital and about a third who are discharged will die within the year. Doctors say patients are not being effectively diagnosed in the community.

Lynn Mackay-Thomas, chief executive of the BSH, said: “We are facing a tsunami of hospital admissions if we do not systematically find those with heart failure early or at highest risk of developing heart failure.

“It’s a ticking time bomb. A national, sustainable and centrally commissioned programme to find people before they become acutely unwell can help change this trajectory. We have the knowledge and treatments to transform people’s lives and prevent many avoidable deaths.”

A report by the Health Foundation published in July 2023 on projected patterns of illness in England reported that the number of cases of heart failure in England was forecast to increase by 92% between 2019 and 2040. This compares to a 31% projected increase for cancer and a 45% increase for dementia.

Data is being analysed from GP surgeries in a pilot project supported by clinicians and the BSH to identify those at risk of heart failure who have not yet been diagnosed. A report published this month in the British Journal of Cardiology says at present there is a missed opportunity for earlier diagnosis.

Abudullah Arshad, 28, a civil engineer from Chigwell, London, was diagnosed with heart failure in June 2018 after experiencing severe heart palpitations. He said: “I would do a bit of exercise, and I could see my heart pumping through my shirt because it was pumping so fast.”

Arshad said he made repeated visits to a walk-in medical centre and a hospital emergency department before he was finally diagnosed in a visit to another hospital.

He said: “As soon I was diagnosed I was bed-ridden. I was told if I did anything, I could drop dead with a cardiac arrest.

“I was shocked at what happened. How can someone go to hospital with heart failure and get misdiagnosed? I could have died at any second. I was not just a danger to myself, but anyone around me. And it was not picked up on numerous occasions.”

Arshad now takes drugs which have improved his heart function. He married his wife Shazreen in December 2020 and the couple have a 16-month-old son, Zahian.

Dr Henry Oluwasefunmi Savage, a consultant cardiologist who specialises in the management of heart failure and is chair of the policy and media committee of the BSH, said: “We have big national campaigns to raise awareness for patients for heart attacks and big national campaigns for patients with stroke, but there is no national campaign for heart failure.

“It’s a tragedy considering that we have the therapies to make people better. Politicians and policy-makers need to recognise that there is a problem and it’s a problem that’s going to explode. This is not a death sentence.

“When you diagnose earlier and treat people earlier on, you see a lot of benefits and can help people feel better and live longer,” he added.

A BSH initiative, 25in25, aims to reduce heart failure deaths by 25% in the next 25 years. It says patients who may be suffering from the condition should recognise these key symptoms: fighting for breath, fatigue and the build-up of fluid in the body.

An NHS spokesperson said: “The NHS remains committed to saving thousands more lives from cardiovascular diseases, as set out in the long-term plan, and has rolled out a range of preventative measures to support people to take control of their own health, including weight management programmes, stop smoking services, and blood pressure checks on the high street, as well as additional testing through GPs to speed up detection of heart conditions.

“Improving the detection and control of high-risk conditions, such as atrial fibrillation, hypertension and high cholesterol, is among the interventions being rolled out to keep on top of cardiovascular risks, and thousands more people are now being supported to manage their condition more effectively than before the pandemic, reducing the likelihood of heart attacks and heart failure.”