One in six Portuguese people have heart failure and 90% don’t even know it

One in six Portuguese over 50 suffers from heart failure, a number that has almost doubled since estimates two decades ago, and about 90% don’t even know it, a study published on Tuesday said.

“We already expected that we would have a much higher percentage of patients with heart failure than what was diagnosed 20 years ago, especially because the way of diagnosis has changed, the criteria have changed (…) and the population has changed greatly. But I admit, we didn’t really expect results of this magnitude,” chief researcher Kristina Gavina told Lusa.

The official also believes that these data indicate a “very significant public health problem” that should change the way heart failure is viewed in Portugal.

The Porthos study, led by the Portuguese Society of Cardiology in partnership with the NOVA School of Medicine, included more than 6,000 people over 50 years of age registered with the National Health Service (SNS) on the Portuguese mainland and updated estimates from 1998, which showed that before prevalence, which amounted to about 400 thousand Portuguese with heart failure and which today reaches 700 thousand.

Stressing that the population is now much older – with an increasing number of comorbidities that are directly related to heart failure, such as diabetes, hypertension and obesity – the official calls for urgent action to be taken to more accurately diagnose precociousness.

Expressing surprise at the incidence found in this study, which was carried out between December 2021 and September 2023, the specialist said the results left researchers alarmed: “The Portuguese don’t know because we don’t diagnose them either.” .

“Family doctors themselves (…) often do not know that these people may have heart failure, and cannot refer them to other, more differentiated places where a diagnosis can be made,” the researcher admitted, emphasizing that these doctors “ very limited” in the tools they can use for diagnosis.

The tool used in this study to understand whether a person might have heart failure—in this case, a blood marker test—is not supported by SNS, he said.

“Usually a family doctor in Portugal does not have access to this kind of examination, which obviously means that he is more limited in his ability to identify these people,” explained Cristina Gavina.

He recalled that scientific societies themselves recognized this research as a necessity many years ago, but until now it has not been considered a priority.

Now that the data has become known, “everything changes”: “It’s more than obvious that these people need [de fazer este exame] when they have suggestive symptoms such as fatigue on exercise, shortness of breath at night or swollen legs,” he said.

The specialist recalled that most of the costs associated with heart failure in Portugal are related to hospitalization and that at the moment the disease is diagnosed at a stage where it becomes more costly for the system.

“The key word here is prevention, on two levels: one focuses on the control of risk factors that can lead to heart failure (…) and the other on early diagnosis of those who already have heart failure.”

He acknowledges that many of these patients are “filling the wards today” and that this represents “an incredible burden on the health system.”

A work published in 2020 in Revista Portuguesa de Cardiologia estimated that the total costs of heart failure due to the consequences of demographic evolution will reach 503 million euros in 2036. However, at that time the estimate indicated the existence of 400 thousand euros. The Portuguese suffer from this syndrome, and the data revealed today is almost double this value (700 thousand).