The very oldest in our society are missing out on simple heart treatments which can prolong and improve their quality of life, Newcastle heart experts say.

Studying a group of people aged 87 to 89 years old, the team of researchers at Newcastle University found that a routine test in the home revealed that around a quarter of them had undiagnosed heart problems which could be treated with established and cost-effective treatments.

In the study, funded by the British Heart Foundation (BHF), the team visited the homes of 376 people aged 87 to 89 years old and carried out echocardiograms -heart scans- using portable instruments.

Publishing today in Heart, they reveal that around a quarter (26%) of the people involved had a previously undiagnosed heart problem, in particular, impairment of left ventricular systolic function. Affected people’s hearts do not contract strongly enough, which can leave them breathless and lead to heart failure. The condition is treatable with established drugs such as beta-blockers and ACE inhibitors.

BHF Professor Bernard Keavney, a cardiologist at Newcastle University, and the Newcastle upon Tyne Hospitals NHS Foundation Trust, who led the study, admits to being taken aback at the extent of the problem: “We were surprised to discover just how many older people have heart problems. Many of these people could be treated with drugs that we know work, if their condition were recognised.

“Our research suggests that it might be practical to offer people over 85 who are breathless, an echocardiogram at home which would reveal these problems. Because this heart problem occurs so often at this age, home checks are  likely to be cost-effective, whereas they wouldn’t be in  younger people.

"In those people found to have hearts that were not pumping strongly enough on a home scan, medication could be considered. This would improve their quality of life and it’s likely to slow their progression to heart failure.

“With heart failure, prevention is definitely a priority. Older patients coming into hospital with worsening heart failure is one of the largest sources of expenditure for the NHS. The number of people over 85 is already soaring, and this will continue for the foreseeable future so anything we can do to improve the heart health of our oldest old is likely to have a big impact.”

Taking part in the research were people involved in the Newcastle 85+ study, a unique study of the health of more than one thousand people from Newcastle and North Tyneside born in 1921.

“This is a group of people who are routinely excluded from trials of treatment on the grounds of their age,“ adds Dr. Joanna Collerton, Senior Clinical Research Associate at Newcastle University and the study’s co-lead author. “What we have discovered is that very many more people in this age group have heart problems compared to those in younger age groups so we need to think about more inclusive trials or trials focusing exclusively on older groups to ensure that as we face a growing older population we offer them the healthiest future.”

Dr Shannon Amoils, Research Advisor at the British Heart Foundation, said: “This study suggests that there are probably many more very elderly people in the community with heart problems than we previously thought . And many have symptoms like breathlessness that limits their daily activities. Despite this, their heart condition is often not recognised.”
 
“It’s important that this vulnerable group of people doesn’t get overlooked so that they are properly assessed and receive the best treatments to improve their quality of life.” 

This research builds on Newcastle University’s work as part of the Newcastle Initiative on Changing Age and the Newcastle institute for Social Renewal. This the University’s response to the societal challenges including ageing, seeking new ways to make the most of the extensive opportunities associated with increasing human longevity, while at the same time solving some of the problems.

The Newcastle 85+ Study is funded principally by the Medical Research Council and Dunhill Medical Trust.

Reference: heartjnl-2012-302457

published on: 25 July 2012