Heart failure drugs 'could save up to 30,000 lives a year': Study urges wider use of medicines to dilate blood vessels

INCREASED use of drugs known as Ace inhibitors to treat heart failure could save nearly 30,000 lives and pounds 50m a year in direct costs to the National Health Service, experts said yesterday.

The drugs, whose main action is to dilate blood vessels, could dramatically reduce the number of hospital admissions which account for 60 per cent of the cost of treating heart failure to the NHS.

An independent study of the costs of heart failure by Dr John McMurray, a consultant cardiologist, and two health economists from the Western General Hospital, Edinburgh, says that for every 1,000 heart-failure patients treated for three years there would be 50 fewer deaths and 350 fewer hospital admissions.

Dr Philip Poole-Wilson, British Heart Foundation professor of cardiology at the National Heart and Lung Institute, London, said good evidence of the effectiveness of Ace inhibitors had been established over the past two or three years.

'Here is a medical advance whose action in actively reducing mortality is rarely seen in medicine,' he said. 'In Britain we think that 10 to 15 per cent of the population with heart failure have these drugs. It should be 60 to 70 per cent.'

He said heart failure affects 1 per cent of the population and accounts for 5 per cent of hospitals stays. About half die within four years and those with severe heart failure are unlikely to survive for more than a year.

Heart failure is the condition in which heart muscle has been damaged, preventing the heart from functioning properly. The result is tiredness and breathlessness. In severe cases the patient is unable to walk more than a few steps without collapsing.

Heart transplant is the treatment offered to young sufferers. Older and elderly patients are prescribed diuretics to keep down levels of water retained in the body.

The full costs of a heart transplant are pounds 24,000. About 570,000 people suffer from heart failure in the United Kingdom at cost of pounds 360m annually to the NHS. This is more than 10 per cent of what the NHS spends on the whole range of heart diseases.

Heart failure patients stay a long time in hospital when admitted, on average 11-12 days. This accounts for 60 per cent of the costs of treating heart failure, while the present drugs bill only accounts for 7.5 per cent of the total.

Dr Murray and his colleagues have worked out that increased use of Ace inhibitors - there are eight varieties on the market - would reduce hospitalisations by 29,278 a year and save pounds 51.2m.

Dr Poole-Wilson said that prescribing of Ace inhibitors may be low because early trials using very high doses on very sick people caused side effects, including low blood pressure. Some doctors were wary as a result but they now know that low doses are effective. A course of treatments costs about pounds 160 a year for the rest of life.

The drugs would not be suitable for some patients with low blood pressure and people with certain forms of kidney problems.