Heart failure . . . and success
PHILIP B. ADAMSON | 1/24/2019, midnight
Heart failure is becoming more and more common. Nearly 6 million Americans are suffering from it today. That figure will grow to more than 8 million by 2030.
The condition exerts an enormous toll on patients, their families and the economy. Fortunately, medical research has yielded new technology that can help people with heart failure live healthier, fuller lives and reduce overall health care costs. It’s time to fully deploy that technology.
Heart failure occurs when a person’s heart struggles to pump blood. That deprives the body of oxygen and nutrients, which can make performing even basic daily activities, such as walking or climbing the stairs—difficult.
Heart failure hospitalizes more than 1 million Americans annually. About half are back in the hospital within six months of diagnosis; the average stay lasts five days. That's a huge burden for patients and for caregivers, who might not live nearby and thus might have to miss work. In total, the condition costs the U.S. more than $30 billion every year.
The standard treatment regimen for heart failure—take medication, reduce salt intake and stay active—has been in place for years. But it has never been truly effective, largely because it’s complicated and difficult for patients to follow.
Consider medication. Some drugs do help patients. But three-quarters of patients don’t consistently take their medications as instructed. More than one in four never fill a new prescription. And doctors sometimes don’t prescribe all the medication that’s recommended.
Advising patients to eat less sodium is ineffective, too. Do you know how much sodium you consume? Neither do patients. Ninety-seven percent of Americans underestimate—or don’t feel confident estimating—the amount of sodium they eat each day.
As for exercise, many patients don’t have the time, resources or social support to get in recommended workouts.
In other words, the status quo for treatment of heart failure isn’t working. But medical researchers are changing that by developing technologies that can help physicians more effectively monitor and treat heart failure—and improve patients’ quality of life.
Consider one device that measures the heart activity of cardiac patients during rehabilitation training. The smartphone-sized unit helps ensure that workouts are at a safe intensity level and duration. Clinicians can immediately determine if a patient’s heart rate is becoming too fast or irregular. The device is demonstrated to improve the health and recovery of heart failure patients.
Researchers at Harvard University are experimenting with a wearable device that can monitor ankle swelling, a common symptom of worsening heart failure. That could help ensure patients seek medical attention before a major problem occurs.
Or consider an innovation I helped develop at Abbott. The CardioMEMS HF system enables doctors to proactively monitor patients’ pulmonary artery pressure and heart rate remotely. So clinicians can detect worsening heart failure before a patient even feels symptoms and adjust medications accordingly. That helps keep patients out of the hospital.
Indeed, research published in the Journal of the American College of Cardiology last year showed that hospitalizations for heart failure declined 46 percent in patients six months after receiving the device. Based on Medicare claims data, average health care costs per patient were $10,500 lower than in the six months before the implant.
Traditional treatment for heart failure is, itself, failing. We can achieve far greater success by embracing new technology that can better monitor and treat heart failure.
Philip B. Adamson, M.D., is a cardiologist, heart failure specialist and medical director at Abbott.