Critical care


Don’t lose heart J


ust under a million people in the UK are living with heart failure, with 60,000 new cases identified every year. It is predominantly a disease of old age, with diagnosis averaging at 77 years old. As the population ages, the number of people affected increases. For many years, clinicians relied on a suite of treatments that proved moderately effective. The past five years, however, have seen some major developments in the treatment of the condition – and there is real optimism that we will see more in the near future. So, what is the best treatment for heart failure – and what treatments are around the corner? Heart failure means that the heart is unable to pump blood around the body effectively. There are


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two types: one where the heart muscle is weak, known as heart failure with reduced ejection fraction (HFrEF), and the other where the heart muscle is stiff, known as heart failure with preserved ejection fraction (HFpEF). According to Abbas Bitar, clinical assistant professor in the division of cardiovascular medicine at the University of Michigan, historically HFrEF was believed to be the more common type. But we now know the incidence of each to be similar. Beta-blockers, which lower blood pressure and slow the heart rate, diuretics to tackle water retention and angiotensin converting enzyme (ACE) inhibitors – which block the production of angiotensin II in the kidneys – have been used for many years to treat


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Thanks to medical advances, we are living longer than any time in history. But an ageing population brings added risks, one being heart failure. According to the World Heart Federation, there are 26 million people suffering from heart failure globally, and that number is increasing. Kim Thomas speaks to cardiovascular experts Stefan Anker and Abbas Bitar about the technology and therapeutic developments they expect to improve critical care for patients with heart conditions.


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