Heart failure life expectancy is six months shorter in most deprived areas

Heart failure patients living in the most deprived postcodes are at risk of dying six and a half months earlier than patients in the least deprived areas, according to a new study published in the journal BMC Medicine. The research also found that the disparities in risk of death and life expectancy worsened over time.

The study, led by researchers at the University of Leeds, analyzed data from 1,802 heart failure patients in West Yorkshire. After adjusting for factors like age, sex and other conditions, they found life expectancy for people in the most socioeconomically deprived areas was reduced by 2.3 years because of their condition, compared to 1.8 years for people in the least deprived areas.

The study used data from people with heart failure recruited between 2006 and 2014, who were then observed for up to 10 years to assess survival. The average age was 69 years and 73% of participants were male.

While disparities were seen over every time period studied, they continued to worsen—the biggest difference in life expectancy between the most and least deprived areas was seen in the most recent group recruited between 2012 and 2014.

Dr. Oliver Brown, Clinical Research Fellow in Cardiology at the University of Leeds, who led the study, said, “We have shown that despite patients visiting the same hospitals and taking part in the same studies, socioeconomic factors like income, employment, education and housing have an outsized effect on their life expectancy. The next step for us is to explore why these disparities exist.

“We hope this research can be valuable for both health care professionals and policymakers, and that steps can be taken to ensure the disadvantages experienced by those in more deprived areas are reduced.”

Heart failure is a condition in which the heart cannot pump blood around the body as well as it should. It is often caused by a heart attack, high blood pressure or problems with the heart muscle.

Heart failure can be debilitating—affecting a person’s ability to do day-to-day activities—and there are currently no effective treatments to stop the condition progressing. In the study, 72% of people died within five years, although researchers highlight that treatments have improved since the study began in 2006.

The researchers used postcodes and the Index of Multiple Deprivation (IMD) to determine people’s socioeconomic deprivation levels. Every postcode has an IMD score which estimates deprivation based on factors like income, employment, housing and education. People in the study were grouped into three categories: those living in the most, middle and least deprived areas.

Everyone in the study received their normal heart failure treatment, and researchers followed up with them for an average of five years to assess death rates for each category. They then compared these death rates to the those they would expect to see, based on the national average from patients of the same ages and sex.

From this, they found that the risk of death for those in the least deprived areas was 11% higher than expected, corresponding to a loss of life expectancy of 1.76 years. However, for patients in the most deprived areas, the risk of death was 24% higher than expected, and 2.3 years of life expectancy were lost.

The researchers now aim to investigate the factors driving this disparity. By understanding the reasons behind it, they hope to find ways of reducing the difference.

Dr. Sonya Babu-Narayan, Clinical Director at the British Heart Foundation, said, “There is substantial evidence that living in more deprived areas is associated with shorter life span, shorter health span and more cardiovascular disease. I find it troubling to again see statistics that show the cardiovascular survival gap between the rich and the poor is only getting worse.

“That’s why it’s so important that Government prioritizes policies that will help prevent cardiovascular disease and improve access to health care for everyone, including people living in more deprived areas. The recent boost in health funding for deprived regions is a positive first step towards more people living in good health for longer.”

Heart failure patients living in the most deprived postcodes are at risk of dying six and a half months earlier than patients in the least deprived areas, according to a new study published in the journal BMC Medicine. The research also found that the disparities in risk of death and life expectancy worsened over time.

The study, led by researchers at the University of Leeds, analyzed data from 1,802 heart failure patients in West Yorkshire. After adjusting for factors like age, sex and other conditions, they found life expectancy for people in the most socioeconomically deprived areas was reduced by 2.3 years because of their condition, compared to 1.8 years for people in the least deprived areas.

The study used data from people with heart failure recruited between 2006 and 2014, who were then observed for up to 10 years to assess survival. The average age was 69 years and 73% of participants were male.

While disparities were seen over every time period studied, they continued to worsen—the biggest difference in life expectancy between the most and least deprived areas was seen in the most recent group recruited between 2012 and 2014.

Dr. Oliver Brown, Clinical Research Fellow in Cardiology at the University of Leeds, who led the study, said, “We have shown that despite patients visiting the same hospitals and taking part in the same studies, socioeconomic factors like income, employment, education and housing have an outsized effect on their life expectancy. The next step for us is to explore why these disparities exist.

“We hope this research can be valuable for both health care professionals and policymakers, and that steps can be taken to ensure the disadvantages experienced by those in more deprived areas are reduced.”

Heart failure is a condition in which the heart cannot pump blood around the body as well as it should. It is often caused by a heart attack, high blood pressure or problems with the heart muscle.

Heart failure can be debilitating—affecting a person’s ability to do day-to-day activities—and there are currently no effective treatments to stop the condition progressing. In the study, 72% of people died within five years, although researchers highlight that treatments have improved since the study began in 2006.

The researchers used postcodes and the Index of Multiple Deprivation (IMD) to determine people’s socioeconomic deprivation levels. Every postcode has an IMD score which estimates deprivation based on factors like income, employment, housing and education. People in the study were grouped into three categories: those living in the most, middle and least deprived areas.

Everyone in the study received their normal heart failure treatment, and researchers followed up with them for an average of five years to assess death rates for each category. They then compared these death rates to the those they would expect to see, based on the national average from patients of the same ages and sex.

From this, they found that the risk of death for those in the least deprived areas was 11% higher than expected, corresponding to a loss of life expectancy of 1.76 years. However, for patients in the most deprived areas, the risk of death was 24% higher than expected, and 2.3 years of life expectancy were lost.

The researchers now aim to investigate the factors driving this disparity. By understanding the reasons behind it, they hope to find ways of reducing the difference.

Dr. Sonya Babu-Narayan, Clinical Director at the British Heart Foundation, said, “There is substantial evidence that living in more deprived areas is associated with shorter life span, shorter health span and more cardiovascular disease. I find it troubling to again see statistics that show the cardiovascular survival gap between the rich and the poor is only getting worse.

“That’s why it’s so important that Government prioritizes policies that will help prevent cardiovascular disease and improve access to health care for everyone, including people living in more deprived areas. The recent boost in health funding for deprived regions is a positive first step towards more people living in good health for longer.”