TUESDAY, March 12 (HealthDay News) -- A simple blood test
conducted annually in your primary care doctor's office might be a
first step in preventing heart failure, a new study suggests.
The next steps include getting a diagnostic echocardiogram and
then receiving coordinated care between a primary care physician
and a cardiologist, according to the Irish pilot study.
The end result: Only about 5 percent of the middle-aged and
older patients enrolled in this type of program ended up requiring
hospitalization for new-onset heart failure or heart dysfunction,
compared with nearly 9 percent of those treated in the usual
"With 6 million Americans suffering from heart failure -- most commonly due to heart attacks, chronic hypertension, diabetes or obesity -- this blood test can provide a simple way for us to screen those patients at risk and prevent heart failure from developing," said one expert not connected to the study, Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City.
The findings were presented Monday in San Francisco at the
annual meeting of the American College of Cardiology (ACC).
Heart failure is a notoriously tough-to-treat condition in which
the heart's pumping action grows gradually weaker over time. "With
middle-aged adults having a 20 to 30 percent lifetime risk of
developing heart failure, prevention is a critical issue that has
not yet been addressed," Steinbaum said.
The new study sought to remedy that situation. Researchers led
by Dr. Kenneth McDonald, director of the Heart Failure Unit at St.
Vincent's University Hospital in Dublin, focused on a test that
measures blood levels of a hormone called B-type natriuretic
peptide (BNP), which can be conducted in any primary care
Speaking to ACC meeting attendees, McDonald said that numerous
studies "indicate that elevated BNP [blood] levels, above and
beyond other risk factors, indicate a risk for heart failure."
So, his team used the test as the starting point of a
Dublin-area program aimed at spotting people at high risk for heart
failure before the condition sets in. The researchers set up a
coordinated group of 39 primary care practices that all reported to
one cardiac care center in Dublin.
The nearly 1,400 patients included in the study averaged 65
years of age and had no previous symptoms of heart failure. They
were randomly separated into two groups: One received usual care,
while the other got an annual BNP test. If a patient's blood test
showed an elevated BNP level (which occurred in about 42 percent of
study participants), they were then sent on to get an
echocardiogram and were assigned a cardiologist who worked in
partnership with their primary care doctor.
The result: After an average follow-up of more than four years,
42 percent fewer patients in the intervention group went on to be
hospitalized with heart failure or heart dysfunction compared to
those who received usual care. The need for emergency
hospitalizations for cardiac events, such as heart attacks or
strokes, also fell by 46 percent, the study found.
The prevention program "targeted four in 10 at-risk patients and
reduced the rates of left ventricular dysfunction, heart failure
and emergency hospitalizations for major cardiovascular events,"
One reason the program worked so well may be that patients
worked harder to stay healthy once they learned of their elevated
risk. "It was explained to patients that [high BNP] was an
indicator of heart vessel damage and, undoubtedly, I would think
this improved adherence to therapy," McDonald explained.
Steinbaum applauded the effort. "In using this simple blood
test, those patients who were determined to be at risk were more
aggressively followed," she said. "Heart failure is often the end
point of heart disease, and its critical nature leads to a major
drain on the health care system through multiple hospitalizations.
If these patients could be detected prior to getting sick, the
potential of saving lives and saving money is tremendous."
Another expert agreed.
"One of the biggest problems we see in medicine is identifying patients who will develop disease, instead of just treating diseases when they occur," said Dr. Lawrence Phillips, assistant professor in the department of medicine at NYU Langone Medical Center, in New York City.
"Although patients will become symptomatic when they develop active heart failure, more of our time should be spent trying to stop patients from developing and progressing to heart failure," Phillips said.
Research presented at medical meetings is typically considered
preliminary until published in a peer-reviewed journal.
To find out more about heart failure, head to the
American Heart Association.
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