More GP specialists needed to manage rising tide of cardiovascular disease

Heart failure cases are driving up GP workload despite the success of preventative measures to cut the rate of the disease, according to an analysis of UK data.

Rates of heart failure have slightly declined over time, but the ageing and growing population means GPs and other clinicians are dealing with more cases than ever before, Lancet study has found.

Increasing the ranks of specialist cardiovascular GPs could help the profession tackle the increase in workload, one GPSI told GPonline.

In a review of UK statistics, the study found that the number of new cases of heart failure increased by 12% from 171,000 identified in 2002 to 191,000 picked up in 2014.

The researchers, from the University of Oxford, warned that prevention and treatment of heart failure was becoming more complex because people tend to have higher numbers of chronic conditions.

The results suggest people from deprived backgrounds are 61% more likely to experience heart failure than the most affluent people - and at younger ages. Without the socioeconomic gap, there would be 32,000 fewer heart failure cases a year, the researchers said.

Heart failure

The study found that the incidence rate of heart failure cases decreased by 7% from 2002 to 2014 – but the number of existing chronic heart failure cases increased by 23%, likely a result of people living longer after heart failure.

The results illustrate the success of prevention measures, while highlighting the ‘vast impending burden for healthcare resources in the UK’, the researchers said.

The surge in cases means heart failure now affects a similar number of people as those affected by breast, prostate, lung and bowel cancer combined.

Dr Mike Kirby, a GP in Hertfordshire with special interest in cardiovascular disease, said there was a need for more GPs with special interest in the area.

‘The deprivation gap is well described and needs a targeted approach to reduce cardiovascular disease by a focus on addressing risk factors in those at the greatest risk,’ he said.

‘They are right complexity has increased with increased comorbidity and age, in addition to the new treatments available, which have prolonged survival.

Cardiovascular disease

‘The complexity needs a multidisciplinary approach with CCGs facilitating shared care using specialist nurses and dedicated clinics with access to echocardiography. We also need more GPSIs and local enthusiasts to support the practices.

‘The key is getting the patients on the right evidence base treatments at the right dose. This would reduce hospital admissions which is where much of the cost lies.’

Lead author Professor Kazem Rahimi said: ‘Our findings have important implications for healthcare resource planning and prevention strategies, as the number of people affected by heart failure grows and places an ever-greater burden on health services.

‘To counter this, we need stronger public health action in disease prevention, improved resource planning, and efficient and effective care for newly-diagnosed patients and those surviving heart failure.

‘The disparities we have identified in the UK point to a potentially preventable nature of heart failure that still needs to be tackled, and to potential opportunities for more targeted and equitable prevention strategies.’

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