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. Falling short: How Canada is failing people with heart failure and how we can change that reveals that despite progress, navigating through siloed systems remains difficult and significant gaps still exist in diagnosis, treatment and support.
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 a new Heart & Stroke poll* heart failure touches one in three Canadians, either because they have it themselves or because it affects a family member or close friend.
“Heart failure is an epidemic. It’s one of the fastest growing cardiovascular conditions in the world,” says Dr. Anique Ducharme, President of the Canadian Heart Failure Society, a professor of medicine at Université de Montréal and a cardiologist at the Montreal Heart Institute.
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 costs everyone
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.
“It is absolutely a full-time job,” says Heather Lannon, who cared for her husband, Jamie, for nine years after his heart failure diagnosis.
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.
Complex, chronic, incurable – and misunderstood
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.
According to the Heart & Stroke poll Canadians do not understand the condition or the urgency:
- Four in 10 Canadians do not understand what heart failure is.
- 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.
Fighting on all fronts to beat 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.
“I thought I was invincible. Heart failure brought me to my knees,” says Kevin Lobo, who was an athletic 38-year-old when he was diagnosed with heart failure. A life-saving stent and medications, and eventually open-heart surgery helped him manage his condition. He remains upbeat and determined to live a full life. “I still drive. I still go to the gym. I still play golf. I do everything.”
Unfortunately, different circumstances can impact the treatment and support people with heart failure receive including ethnicity, income, gender, and location.
According to a Heart & Stroke Heart Failure Resources and Services Inventory** there is room for significant improvement in many areas of heart failure care across the country. For example, 27% of hospitals do not have access to one of the procedures that is essential for diagnosing heart failure (natriuretic peptide testing) and 16% of hospitals do not follow published heart failure care guidelines.
“There has been some progress to improve outcomes and quality of life for people living with heart failure, informed by important research. But much more could — and should — be done, especially as heart failure numbers continue to grow,” says Dr. Patrice Lindsay, Director, Health Systems, Heart & Stroke. “That’s why Heart & Stroke brought together leading cardiac organizations and others from across the country to drive an action plan, informed by nurses, cardiologists, pharmacists and people living with heart failure and their caregivers.”
The action plan emphasizes an integrated approach to heart failure across Canada, including:
- integrated systems of care
- evidence-based care driven by high quality research
- access to specialized care
- coordinated and seamless transitions of care
- support for people living with heart failure and their families and caregivers
Other areas that will improve outcomes and quality of life for people living with heart failure include improved access to necessary medications through a national, universal pharmacare program and expanded access to virtual care.
*The national, bilingual online poll was conducted by Environics Research Group, with 2,257 Canadian residents 18 years and older, Nov. 8-13 2021.
** The Heart & Stroke Heart Failure Resources and Services Inventory was conducted throughout 2021 and the interim data provided in this report includes responses from 405 of the 654 acute healthcare facilities in Canada completed as of Nov. 18, 2021. Some values may have minor changes once full data collection is complete.
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Life. We don’t want you to miss it. That’s why Heart & Stroke leads the fight to beat heart disease and stroke. We must generate the next medical breakthroughs, so Canadians don’t miss out on precious moments. Together, we are working to prevent disease, save lives and promote recovery through research, health promotion and public policy. Heartandstroke.ca @HeartandStroke