The average age of a person with a new diagnosis of heart failure in the UK is now 80, and such a person is as likely to be female as male, to have 5–6 co-morbidities, and to be frail.1 Delivering appropriate care is a challenge, particularly where the evidence from clinical trials may be in patients who are typically 20 years younger and with less complex medical and social needs. Increased awareness of the need for a more holistic approach, with shared decision making, and advance care planning, is improving the experience and outcome of care, but there is marked variation across the NHS.2 3This talk will briefly summarise some of the recent advances in treating heart failure – particularly for those with systolic impairment of the left ventricle, and for those with valve disease. Mechanical circulatory support has improved greatly in recent years but is only ever an option for a tiny minority of patients. Treatment of co-morbidities, such as atrial fibrillation and diabetes, have also improved the outcome for those with heart failure. Despite much effort, cellular and genetic therapies remain a distant prospect. Digital approaches to care, and self-management, show considerable promise but integrating such approaches into a traditional healthcare system has proven challenging.The prognosis of heart failure has improved dramatically for many patients over the past 30 years –but the residual risk of mortality and urgent hospitalisation means that there is much work to be done.ReferencesConrad N, Judge A, Tran J, et al. Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals. Lancet 2018;391:572–580.Chronic heart failure in adults: diagnosis and management (NG106). National Institute for Health and Care Excellence, September 2018. Available at: https://www.nice.org.uk/guidance/ng106Failure to Function: a review of the care received by patients who died in hospital following an admission with acute heart failure. National Confidential Enquiry into Perioperative Deaths, November 2019. Available at: https://www.ncepod.org.uk/2018report2/AHF%20full%20report.pdf
Long-Term Temporal Trends of Polychlorinated Biphenyls and Their Controlling Sources in China
