Heart failure

We want to help prevent and treat heart failure, a leading cause of death

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The patient experience
Our commitment
Our people
Discover more about CVRM

Congestive heart failure, also known as heart failure (HF) is a chronic and progressive disease¹ that affects 64 million people worldwide.² In the US, fifty percent of patients will die within five years of diagnosis,³and it is becoming noticeably more prevalent with our aging population.⁴ Heart failure is the leading cause of hospitalisation for those over the age of 65 and also impacts quality of life and overall health outcomes.^5,6 Despite medical advances, it remains as life-threatening as some of the most common types of cancer in both men (prostate and bladder cancers) and women (breast cancers).⁷

The growing burden for chronic heart failure patients

Suffering from one disease is enough of a burden, but all too often heart failure exists alongside other diseases. One of the leading causes of heart failure is underlying coronary artery disease.When co-existing with heart failure, it is associated with worse outcomes and increased mortality of patients.⁸

Additional cardiovascular risks

Not only is heart failure associated with other cardiovascular diseases, but it also commonly occurs together with renal and metabolic diseases. For example, after five years of a type-2 diabetes diagnosis, two-thirds of elderly patients experienced left ventricular dysfunction, which often leads to heart failure (left sided heart failure in this case), and an estimated 40% of patients who have been hospitalised for heart failure have type-2 diabetes.^9,10 Heart failure is also developed by up to one in five patients with chronic kidney disease (CKD),¹¹ making it the leading CV complication in CKD patients.¹²

Risk of hyperkalaemia

Heart failure management can often be challenging due to the fact that some treatments may cause complications, such as hyperkalaemia (HK). HK is a serious condition characterised by elevated potassium in the blood, sometimes associated with treatment with RAAS inhibitors (RAASi), which are commonly prescribed for treating HF.^13,14 4 in 10 patients with heart failure who are taking renin-angiotensin-aldosterone-system (RAAS) inhibitors develop hyperkalaemia at some point. In severe cases, hyperkalaemia can potentially cause temporary paralysis, cardiac arrhythmia and cardiac arrest.^15,16

Addressing heart failure and other CVRM diseases

As research continues to unveil further insights into the reality of the comorbidities of heart failure, it is vital that we consider the patient as a whole, not merely focusing on one disease, and adapt our research, development, and treatments accordingly.

We dare to do things differently and challenge ourselves to better understand how our portfolio can be used to help address multiple risk factors or comorbidities across cardiovascular, renal, metabolic diseases (CVRM). We endeavour to support heart failure patients throughout their journey, ease the challenges they endure and ultimately reduce the heart failure risk by revolutionising the current care possibilities provided.

The patient experience

I’ve been having an ache in my chest for about two years. My skin felt tight around my legs, and even my fingers.

Facing daily life with emotional worry and physical burden

Patients suffering from chronic heart failure disease often feel daily activities, including even carrying groceries, are energy-depleting tasks. Alongside the physical challenges heart failure poses, patients may become tormented with worry, as they fear normal tasks could worsen their condition or even threaten their life. To add to patients’ pain, individuals suffering from heart failure may furthermore be impacted by interconnected cardiovascular, renal, or metabolic diseases.¹⁷

Although life expectancy of heart failure patients improved in the last decades due to advanced treatment options, mortality remains high, even higher than in certain common cancers in both men (prostate and bladder cancers) and women (breast cancers).^7,18In the US, about half of the people diagnosed with chronic heart failure will die within five years from diagnosis, demonstrating the need for improved prevention and treatment measures.³

It is not only our goal to alleviate the persistent feeling of angst which drives HF patients to despair, but to also raise awareness of the importance of warning signs of heart failure, as they can also be a means to detect other interrelated diseases.^{19, 20}

64 million

people are impacted by heart failure worldwide²

#1 cause of hospitalisation

for those over the age of 65 is heart failure⁵

4 in 10

chronic heart failure patients who take RAAS inhibitors at some point develop hyperkalaemia¹⁵

25-40%

of people with T2D will develop chronic or acute heart failure²¹

5-year survival rate

of both men and women with heart failure has been shown to be lower than some of the most common cancers in both men (prostate and bladder cancers) and women (breast cancers)⁷in Scotland⁷

Our commitment

Today, we are focusing on developing our therapies to help reach even more patients affected by heart failure. Not only do we strive to bring the right treatment and introduce new life-changing medicines for patients suffering from heart failure, we also dedicate our efforts to bringing awareness to the forefront of our ambition to highlight the importance of tackling one of the leading causes of death and push the boundaries of heart failure treatment guidelines.

World Heart Federation

Together with the World Heart Federation (WHF), we are driving global action to prevent, control, and reduce the burden of cardiovascular disease and associated complications. We are collaborating to progress evidence-based policy solutions, with a strong focus on heart failure, and increase the level of awareness on the devastating burden of heart failure worldwide.

Global heart failure awareness

We work with multiple different partners including the European Society of Cardiology (ESC), to spread knowledge about heart failure as an international health issue. Together with these established partners, we developed a series of informative materials, such as infographics and social media posts, to not only activate new channels to raise awareness to a wider audience, but also reinforce heart failure as a global pertinent problem that demands our urgent attention.

Driving healthcare system change with ACT on Heart Failure

ACT – Accelerate Change Together – on Heart Failure is a cross-functional programme which operates at the country level to achieve healthcare system change. Through the development of localized strategies, ACT on Heart Failure calls for healthcare systems and stakeholders to adopt a more proactive approach to early diagnosis, improved management and, where possible, prevention of heart failure to reduce the risk of hospitalisation and life-threatening events.

Our people

AstraZeneca has one of the richest clinical pipelines today in the heart failure area in terms of prevention and treatment of various subtypes of heart failure. Our ambition is indeed to eventually reverse the disease and to eradicate heart failure.

Li-Ming Gan Medical Science Director, Early Clinical Development (Cardiovascular and Metabolism), BioPharmaceuticals R&D

Regina Fritsche-Danielson

SVP, Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D

View Regina’s profile

Li-Ming Gan

Medical Science Director, Early Clinical Development (Cardiovascular and Metabolism), BioPharmaceuticals R&D

View Li-Ming’s profile

Discover more about CVRM

We aim to save the lives of people who suffer from cardiovascular disease, heart failure, chronic kidney disease and diabetes, by advancing CVRM solutions and addressing shared risk factors between these distinct but interrelated disease areas.

We aim to treat life-threatening complications and halt disease progression to provide millions of patients living with chronic kidney disease with a longer and greater quality of life.

Our focus is to transform the lives of the millions of patients living with metabolic diseases. We aspire to move healthcare professionals to treat beyond HbA1C, prevent early cardiovascular and renal complications and explore non-alcoholic steatohepatitis (NASH).

Our ambition is to eliminate the remaining cardiovascular (CV) risk of patients with CV disease and stopping disease progression, therefore preventing CV events from occurring and protecting the lives of millions of patients.

References

American Heart Association. What is Heart Failure?; 2017 [cited 2019 Sep 5]. Available from: URL: https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure.
GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1211-1259.
Mozaffarian D, et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016;133(4):e38-360.
Savarese G, et al. Global Public Health Burden of Heart Failure. Card Fail Rev. 2017;3(1):7-11.
Azad N, Lemay G. Management of chronic heart failure in the older population. J Geriatr Cardiol. 2014;11(4):329–37. doi:10.11909/j.issn.1671-5411.2014.04.008
European Society of Cardiology (ESC). One in five people will develop heart failure. ScienceDaily. 2015. Available from: www.sciencedaily.com/releases/2015/05/150505111934.htm [Accessed June 2018].
Mamas MA, et al. Do patients have worse outcomes in heart failure than in cancer? A primary care-based cohort study with 10-year follow-up in Scotland. Eur J Heart Fail. 2017;19(9):1095–104.
Gheorghiade M, et al. Navigating the crossroads of coronary artery disease and heart failure. Circulation. 2006;114(11):1202–13.
Faden G, et al. The increasing detection of asymptomatic left ventricular dysfunction in patients with type 2 diabetes mellitus without overt cardiac disease: data from the SHORTWAVE study. Diabetes Res Clin Pract. 2013;101(3):309-16.
Seferović PM et al. Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2018; 20(5):853–72.
House AA, et al. Heart failure in chronic kidney disease: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2019;95(6):1304–17.
Segall L, et al. Heart failure in patients with chronic kidney disease: A systematic integrative review. Biomed Res Int. 2014;2014:937398.
National Kidney Foundation. "Clinical Update on Hyperkalemia." 2014. Accessed 16 May 2018. https://www.kidney.org/sites/default/files/02-10-6785_HBE_Hyperkalemia_Bulletin.pdf.
Kuijvenhoven MA, Haak EA, Gombert-Handoko KB, Crul M. Evaluation of the concurrent use of potassium-influencing drugs as risk factors for the development of hyperkalemia. Int J Clin Pharm. 2013 Dec;35(6):1099-104.
Thomsen RW, et al. Elevated Potassium Levels in Patients with Congestive Heart Failure: Occurrence, Risk Factors, and Clinical Outcomes: A Danish Population-Based Cohort Study. J Am Heart Assoc. 2018 May 22;7(11).
Epstein M, Reaven NL, Funk SE, McGaughey KJ, Oestreicher N, Knispel J. Evaluation of the treatment gap between clinical guidelines and the utilization of renin-angiotensin-aldosterone system inhibitors. Am J Manag Care. 2015 Sep;21 (11 Suppl):S212-S220.
Arnold SV, et al. Burden of cardio-renal-metabolic conditions in adults with type 2 diabetes within the Diabetes Collaborative Registry. Diabetes Obes Metab. 2018;20(8):2000–3.
Bytyçi I, Bajraktari G. Mortality in heart failure patients. Anatol J Cardiol. 2015;15(1):63–8.
Lawson CA et al. Comorbidity health pathways in heart failure patients: A sequences-of-regressions analysis using cross-sectional data from 10,575 patients in the Swedish Heart Failure Registry. PLoS Med 2018; 15(3):e1002540.
American Heart Association. Warning signs of Heart Failure. 2017. Accessed 12 Sept 2019. https://www.heart.org/en/health-topics/heart-failure/warning-signs-of-heart-failure
Rosano GM, et al. Heart failure in patients with diabetes mellitus. Card Fail Rev. 2017;3(1):52-55.