Transforming cardiovascular care and the burden of heart failure

At AstraZeneca, we believe we play a pivotal role in advancing the understanding of HF and driving better patient outcomes. In partnership with healthcare systems around the world, by 2030 we aim to reduce heart failure related hospital admissions by 50% and premature death by 20%. Through global collaborative initiatives, our ambition is to reduce the burden of HF on patients, healthcare systems and society.

HF is a complex and progressive disease

HF is a long-term condition with acute exacerbations that worsens over time as the heart becomes too weak or stiff to pump enough blood to meet the body’s needs, leading to debilitating physical and emotional symptoms.^1,4 Patients living with HF often experience shortness of breath, fatigue, swelling in legs, sleep disturbances, chest pain and depression.^4,7 These symptoms significantly impair daily activities, resulting in compromised quality of life and high hospitalisation and mortality rates.^4,8-10

Beyond the impact of HF on patients, it also imposes a significant economic burden on healthcare systems. Globally, the cost of HF is estimated to be $346.17 billion, with projections indicating a staggering 127% increase in HF costs by 2030.^11,12 Hospitalisations, responsible for up to 87% of expenses, are a major driver of healthcare costs associated with HF.¹

HF is often underdiagnosed with delays in diagnosis and high mortality rates

Studies have shown symptoms of HF can manifest up to five years before an official diagnosis, affecting over 40%* of patients.¹³ About 75%* of HF cases are unfortunately identified in a hospital setting.¹⁴ But around 46%** of patients with HF previously reported symptoms to their primary care physicians prior to diagnosis in acute care settings.¹⁵

The consequences of delayed HF diagnosis can lead to significantly poor clinical outcomes. Delayed detection often results in more severe HF at the time of diagnosis, hindering access to preventive medications and leading to an increase in cardiovascular events and hospitalisations.¹⁶

Despite advancements in HF treatment and prevention, morbidity and mortality rates remain high. Within just one year of an HF diagnosis, 24-33% of patients die from the condition.⁵ Despite its prevalence and impact, however, public awareness of HF remains relatively low.^1,17

Who is at risk for HF?

HF can vary in cause and area of the heart affected, but a person is at increased risk if they have a history of coronary artery disease, heart attacks, chronic kidney disease (CKD), diabetes or hypertension.^18-20

Lifestyle behaviours can also increase the risk of HF, especially for people with one of the pre-existing conditions. These behaviours include smoking tobacco, eating foods high in fat, cholesterol, and sodium, and physical inactivity.^21,22

Early HF diagnosis may slow progression and help manage comorbidities

Early detection of HF plays a crucial role in preventing poor clinical and patient outcomes.²¹ Timely diagnosis allows for early intervention and access to appropriate treatments, which can slow the progression of the disease and improve quality of life.^4,21 Medical guidelines and guideline-directed medical therapies (GDMT) are an important part of the solution as they help provide patient-centric recommendations for clinicians to diagnose and manage patients.²²

For HF care teams, medical guidelines include the European Society of Cardiology (ESC) Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure and the American College of Cardiology/American Heart Association/Heart Failure Society of America Guidelines for the Management of Heart Failure.^3,22 These guidelines provide insights into the distinct types of HF, ways to approach the disease, and recommendations for early diagnosis and intervention.^2,22

Delayed diagnosis, however, can lead to more severe HF at the time of diagnosis, making it challenging to effectively manage the condition.¹⁷ Late access to preventative care and interventions may also result in missed opportunities to address risk factors and implement measures to prevent the worsening of HF.¹⁷ This underscores the importance of timely screening and diagnosis to ensure patients receive necessary care and support as early as possible.^2,17

The presence of comorbidities adds complexity to HF management. Many HF patients have other concurrent medical conditions such as high blood pressure, diabetes or CKD.^2,24,25 These comorbidities can further impact the clinical outcomes and treatment approaches for HF patients. It is crucial for healthcare providers to consider these additional conditions when developing comprehensive management plans for patients with HF. By leveraging guidelines and GDMT to address both HF and comorbidities, healthcare professionals can optimise treatment strategies and improve patient outcomes.^2,22

Our commitment to people living with HF

We consider ourselves as a central part of HF healthcare and are working with the cardiovascular community to transform the delivery of HF care. By 2030, our ambitious goal is to reduce HF mortality rates by 20% and HF-related hospitalisations by 50%. We also aim to increase the utilisation of guideline-directed medical therapy (GDMT) from less than 5% in 2020 to 35% by 2025.

To realise this ambition, we launched the Accelerate Change Together (ACT) on HF programme to drive comprehensive HF change across the healthcare ecosystem. Through ACT on HF, we aim to elevate HF as a healthcare priority and highlight the development of national strategies. We’re also working to support healthcare providers (HCPs) to enhance prevention and diagnosis capabilities, and partner with them to improve HF management and ensure all HF patients receive optimal and integrated care.

Increasing awareness and education on HF and GDMT are particularly important components of ACT on HF, as early detection and intervention can help patients receive optimal guideline-directed care.²³ Since the launch of ACT on HF in 2020, we estimate we have contributed to raising HF awareness among more than 80 million people and supported more than 400,000 HCPs receiving HF education.

Projects to encourage urgency of early HF screening and diagnosis

To drive change in HF, we are working together with global, regional and local partners. Through our collaborative efforts, we aim to implement innovative approaches, leverage the latest technologies, and undertake large-scale initiatives to improve early diagnosis rates and enhance the lives of individuals affected by HF worldwide.

We are committed to expanding understanding around HF and have generated real-world evidence on:

Patient empowerment is key to HF intervention

In addition to disease awareness, we prioritise patient empowerment and help amplify their voices through publications in peer-reviewed journals. As part of our ACT on HF initiative, we supported a co-authored article with a cardiologist to encourage closer collaboration between HCPs and their patients with HF to highlight challenges and opportunities of people living with HF.²⁶

Through our collaborations, we actively support initiatives that encourage individuals living with HF to self-manage their care. These initiatives include providing patients with the resources, tools and educational materials needed to effectively manage their health including connecting them with materials such as the ESC patient guidelines for self-managing HF.²⁷

HF requires immediate collaborative action

Through joint efforts, we can make a profound difference and forge a future with improved HF outcomes for all. The complexities of HF require the entire cardiovascular community to transform HF management and care.  We remain steadfast in our commitment to transforming HF and achieving sustainable change for patients all over the world.
 

*Data refers to a UK population
**Data refers to a US population

Veeva ID: Z4-57460
Date of preparation: August 2023