Heart Failure in Australia

Heart failure occurs when the heart begins to function less effectively in pumping blood around the body. It can occur suddenly, although it usually develops slowly as the heart gradually becomes weaker. Heart failure can result from a variety of diseases and conditions that impair or overload the heart, including heart attack, high blood pressure, damaged heart valves or cardiomyopathy. There is no cure for heart failure. In 2022, an estimated 144,000 people aged 18 and over were living with heart failure, and 71% are 65 and over. Heart Failure was the underlying cause of death in 5000 cases and was an associated cause in a further 28,600 deaths.

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Heart Failure Workshops

The ACvA convened a series of national meetings and workshops, facilitated by Professors Peter Macdonald and Patricia Davidson to identify research priorities across the research pipeline that, if addressed, have the potential to improve heart failure management, enhance patient outcomes, and reduce hospital readmission and health system pressures. From these workshops heart failure and frailty was identified as a key research priority.

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Heart Failure and Frailty Priority Area

Heart failure and frailty frequently coexist, exacerbating each other's impact and resulting in poorer outcomes. More than half of all patients with heart failure are affected by frailty leading to worse outcomes. Importantly, frailty is largely reversible through proper exercise, nutrition, social engagement and support networks, and optimised medication use. However, these frail patients with heart failure are often not receiving guideline-based care due to perceived risk of adverse health outcomes.

Despite its impact, frailty is often under recognised, under treated and underfunded. Frailty is not routinely assessed in clinical practice, even though it strongly predicts poor outcomes and can be reversed with timely treatment. Developing new models of care for heart failure and frailty has broad application for improving the quality of life and independence for the aging Australian population.

There is currently no consensus on when or how to measure frailty, even though assessment is essential for identifying individuals who may benefit from interventions. Proven programs that prepare high-risk, frail patients before heart surgery are effective (prehabilitation) but not widely used. There's an urgent need for standardised approaches in this important area.

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Co-leads: Dr Julee McDonagh and Professor Caleb Ferguson.