New Heart & Stroke Report shows how Canada is failing people with heart failure

BY SIMONE J. SMITH

“Heart failure is an epidemic. It’s one of the fastest growing cardiovascular conditions in the world.” Dr. Anique Ducharme, President of the Canadian Heart Failure Society

Heart failure is a serious and growing problem in Canada, putting a significant strain on people living with the condition, their families and healthcare systems according to a new Heart & Stroke report.

Heart failure is a chronic condition caused by the heart not functioning as it should or by a problem with its structure. It can happen if the heart is too weak or too stiff, or both. This often results in fatigue and shortness of breath, and those living with the condition often experience depression and anxiety and reduced quality of life. The toll can also be substantial on family and other caregivers who manage medications, medical appointments and frequent trips to the emergency department.

Anything that damages the heart can lead to heart failure. Experts expect heart failure will continue to rise due to the aging population and an increase in younger people being diagnosed due to better detection tools and increased risk factors. As well, the COVID-19 virus can cause heart damage which can lead to heart failure, and the pandemic disrupted healthcare services resulting in people with existing heart conditions not accessing care and ending up sicker.

Heart failure is one of the top reasons why people in Canada are hospitalized. In fact, it is often referred to as a ‘revolving door’ condition because one in five heart failure patients will be readmitted to hospital within a month of being discharged. By 2030, the healthcare costs associated with heart failure in Canada are expected to reach $2.8 billion per year.

Most people with heart failure have at least one other significant cardiovascular condition and often up to seven (for example diabetes, hypertension, atrial fibrillation), complicating treatment and impacting quality of life. Nearly half of patients with heart failure will die within five years of being diagnosed.

The report reveals that heart failure touches one in three Canadians, either because they have it themselves or because it affects a family member or close friend.

Other data highlighted in the report includes:

• In Canada, there are 750,000 people living with heart failure and 100,000 people are diagnosed with this incurable condition each year.
• According to the Heart & Stroke poll, Canadians do not understand the condition or the urgency:

o   Four in ten Canadians do not understand what heart failure is.

o   One in three Canadians do not know that heart failure is on the rise.

o   Two in three Canadians do not know there is no cure for heart failure.

Early diagnosis, lifestyle changes, access to medication, medical devices like pacemakers, artificial heart valves or pumps, and community support can improve health outcomes and quality of life. Unfortunately, different circumstances can impact the treatment and support people with heart failure receive including ethnicity, income, gender, and location.

I wanted to learn more about this because I know that cardiovascular diseases are common in people from the Caribbean. In an article “The Risk of Cardiovascular Disease Among Immigrants in Canada” (Sneha A. Sebastian, Chaithanya Avanthika, Sharan Jhaveri, Keila G. Carrera, Genesis P. Camacho L, Ramya Balasubramanian), I learned that cardiovascular disease (CVD) risks are of concern among immigrants and refugees settling in developed host countries. Black immigrants living in Ontario, Canada tend to have more prevalent risk factors of CVD such as type II diabetes mellitus (27.6% male and 94.2% women) vs White Canadians (18.8% male and 21.7% women).

I was delighted to have an opportunity to speak with Dr Peter Liu (Chief Scientific Officer and Vice President of Research at the University of Ottawa Heart Institute). He shared some compelling information that I believe our community needs to know.

“Four in ten Canadians do not understand what heart failure is,” Dr. Liu begins. “The heart is a pumping organ that pumps blood to the rest of the body, and there are various factors to consider. The heart has to work harder, especially if you have high blood pressure, or diabetes. With all this work, the heart muscle can get tired, and this means that it can no longer meet the demands of the body. Blood can back up into the lungs, and in the legs they will swell.”

What the majority of Canadians don’t realize is that this process can be quite silent, and you might not even realize that your heart is failing until you start experiencing symptoms.

“Studies in Africa and also in Caribbean Islands show that there has been an increase in high blood pressure in the last twenty years, and it is getting more severe,” Dr. Liu continues. “There are environmental conditions (eating more processed food, more salty foods, less natural foods), and then you have to take into consideration the technology transition which has led to a sedentary lifestyle.”

Special Notes

One in three Canadians do not know that heart failure is on the rise.

Two in three Canadians do not know there is no cure for heart failure.

“Treatments now are a lot better than before,” Dr. Liu concludes. “The downside is that those who should be getting treatment are not. It is truly a silent killer, by the time they come to us it is too late. What I do is address the risk factors, and lifestyle changes with my patients. Medicines that are appropriate for the patient can make a difference.

We want our heart patients to become their own doctors. The patient lives with the condition, if we can monitor it and address the issues, you can have a much better hold on your situation, and save yourself from a lot of pain and suffering in the future.”