British Society for Heart Failure: 25in25 Summit: Saving lives by changing the trajectory of heart failure globally 

45 health organisations unite to sign declaration to save thousands of lives by

focusing on reducing heart failure deaths

• 45 professional associations, patient groups and NHS organisations unite as leaders to achieve a shared goal of reducing heart failure deaths by 25% in the next 25 years
• As malignant as some common cancers^[i], heart failure is too often missed or overlooked yet it is an endpoint of many cardiovascular and non-cardiovascular conditions
• First imperative: to detect the 385,000 people with heart failure who are currently undetected, undiagnosed and consequently not receiving life preserving treatment
• We are at a crucial point in time to address the growing heart failure epidemic^[ii]

25in25 Summit, London, 9 March 2023: Today, in a momentous ‘first’, experts from 45 top health organisations from the UK, US, Europe and Canada (list below), with key roles in diverting the course of the growing global heart failure epidemic, united as leaders to sign a declaration committing to reducing heart failure deaths by 25% in next 25 years.

Convened by the British Society for Heart Failure (BSH), the 25in25 initiative recognises heart failure as the endpoint for many conditions, cardiovascular and non-cardiovascular. As malignant as some common cancers^[iii], despite growing success due to scientific breakthroughs and increasing understanding, heart failure is too often overlooked.

Heart failure rarely exists alone

Heart failure is caused by structural or functional abnormalities of the heart^[iv]. It is often the final common pathway for the many cardiac conditions that affect heart pump function and therefore the endpoint of almost all cardiovascular disease.

People with heart failure typically have one or more comorbidities (meaning that more than one disease or condition is present in the same person, at the same time). Coronary artery disease (where the arteries that supply blood to the heart become clogged up with fatty substances such as cholesterol) and raised blood pressure are two of the most common precursor conditions^[v]. 98% of those diagnosed with heart failure in the UK live with at least one other long-term condition, such as diabetes and/ or kidney disease^[vi]. Obesity can also be a complicating factor. From epidemiology to pathophysiology, there are overlaps with many other organ systems and clinical specialities. Thus, heart failure must be considered a shared responsibility across the wider healthcare environment and hence the convention of the 25in25 Summit.

Scale of the problem

• The current worldwide prevalence of heart failure is estimated at 64.34 million cases.^[vii]
• This accounts for 9.91 million years lost due to disability (YLDs)^[viii].
• And a worldwide economic burden of heart failure can be estimated at $US 346.17 billion^[ix]
• Worldwide trends in heart failure are set to skyrocket^[x], augmented by the ageing ‘Baby Boomer’ generation.

Heart failure currently takes up 2% of the entire NHS budget.

The human and economic costs are huge.

Over 1 million people in the UK have heart failure, with 200,000 new diagnoses every year. Estimates suggest there are a further 385,000 people with heart failure who are currently undetected, undiagnosed and, consequently, missing out on life-preserving treatments. These numbers are on the rise due to several factors including the anticipated exponential growth in our ageing population.

Currently, in the UK, 80% of heart failure is diagnosed in hospital where 40% of people had symptoms that should have triggered an earlier assessment in primary care in the months prior^[xi]. The 25in25 initiative aims to reduce the mortality from heart failure in the first year after diagnosis by 25% in the next 25 years.  In the UK alone, this would mean 5 fewer deaths for every 100 patients newly diagnosed with heart failure every year, translating to over 10,000 lives saved annually.

The F words: common symptoms of heart failure

Dr Henry Oluwasefunmi Savage, Chair of the BSH Policy & Media Committee, said: “The immediate issue, where we will have most impact on people and services is through detecting the people who have heart failure already and don’t know it. Identifying those at risk of developing heart failure and intervening early is key to the long-term management of cardiovascular diseases. Identified early, we can make a huge difference in the lives of those with heart failure. We have the tools and expertise to manage heart failure well. Everyone needs to be vigilant, to look out for the common symptoms of heart failure — the ‘F words’: ‘fighting for breath,’ ‘fatigue’ and ‘fluid retention.’ If you recognise any of these in yourself or your loved ones, seek medical help early. A simple blood test (NTproBNP) can be used to rule out heart failure or indicate the need for further tests.”

Collaboration to reduce heart failure deaths

Dr Lisa Anderson, Chair Elect of the BSH commented: “By working together with allied organisations and looking through the lens of our population’s health, the 25in25 collaborative can accelerate action towards reducing deaths due to heart failure in the next 25 years. Identifying those with risk factors for and detecting heart failure earlier will lead to sustainable wins across other diseases. Collectively, we will leverage our reach, infrastructure, and human capacity to build a more equitable, inclusive, prosperous and sustainable future for all those in danger of dying from heart failure, regardless of circumstances. Together, we can turn the tide on this life-limiting condition and benefit our communities.”