Weakened Hearts Succumb in Winter

Filed under Medical, News, Science & Research ~ by Press on  4 Aug 2019
Up to 8,800 hospital admissions and hundreds of deaths could be prevented, according to first Seasonal Vulnerability Report.

Thousands of older Australians are being hospitalised during winter, with a 32 per cent spike in admissions compared to summer for deadly and common heart conditions.

Launched today, ‘Peak Winter! A Report on the Seasonal Impact of Heart Failure in Australia’ reveals:

  • 21,400 admissions to hospital this winter due to the most common type of heart failure, where the heart is unable to pump enough blood and nutrients around the body.
  • This represents 5,200 more admissions for heart failure than in summer (almost 60 extra admissions a day) – confirming significant seasonal variability.
  • Overall, of the 73,500 admissions to hospital for heart failure this year, seasonal vulnerability (excess admissions during winter, spring and autumn compared with summer) will contribute to 8,800 admissions.
  • If these 8,800 more admissions due to seasonality were prevented, this would save the health system more than $200 million – as well as preventing hundreds of associated deaths.
  • This is the first time that the number of hospital admissions due to heart failure over four seasons has been analysed across Australia’s states, territories and key localities.

Despite relatively mild winters in most parts of Australia, the Winter Peak in hospitalisation for heart failure in Australia is comparable to northern European countries.

For the first time, a five-point Seasonal Vulnerability Scale, consisting of population age, air pollution, climatic changes, poverty, and rates of heart disease, has been assigned to each state.

  • South Australia scored five-out-of-five for seasonal vulnerability.
  • Tasmania and New South Wales both scored three-out-of-five.
  • Victoria and Queensland both scored two-out-of-five.
  • Western Australia scored one-out-of-five.

Report author, NHRMC Senior Principal Research Fellow and heart failure expert from Torrens University, Professor Simon Stewart said, “There is an alarming spike in the number of people admitted to hospital for heart failure during the colder months. Seasonal variances contribute to almost 9,000 otherwise preventable admissions each year”.

Establishing a clear link between winter and hospital admission for heart failure provides for the first time a new target to identify vulnerable people and reduce complications,” he said.

Even with the best of care, five-to-ten per cent of people with heart failure will die within a month of leaving hospital.

The research points to ‘seasonal frequent flyers’ – people who routinely present to hospital with heart problems exacerbated by the cold. If we include all cardiovascular disease, there is a winter spike of 41,500 hospitalisations compared to summer,” he said.

Professor Stewart says practical measures can be taken to reduce hospital admissions over winter from heart failure. “The number one recommendation is staying warm.

It is important to reduce exposure to the cold and monitor people with heart conditions for worsening symptoms. This is a group of people who typically don’t complain, so it is important that their families look out for the symptoms of worsening heart failure and alert doctors.”

Possible symptoms of heart failure – which may be dismissed as a normal part of ageing – include breathlessness, fatigue, needing to be propped up on pillows to sleep, sudden increase in weight, appetite loss, nausea, persistent cough or wheezing and swollen ankles, legs or stomach.

Report co-author and Melbourne-based expert in Cardiovascular Medicine, Professor Louise Burrell says the scale of temperature change can act as a catalyst for the worsening of pre-existing heart disease.

Colder weather can increase blood pressure, which makes it more difficult for the heart to pump blood around the body. Now is the time to be alert to any deterioration in heart health,” she said.

Professor Stewart says that the number of hospital admissions in the report could be “just the tip of the iceberg, given that it only represents the main type of heart failure”. He believes the total number of hospital admissions related to heart failure is likely to be double that cited in the report.

Numerically, NSW had the highest number of annual hospital admissions due to heart failure (24,400, 7,077 admissions during winter); followed by Victoria (18,900 admissions, 5,479 during winter); then Queensland (13,920 admissions, 4,066 during winter); Western Australia (7,000 admissions, 2,019 during winter); South Australia (6,100 admissions, 1,756 during winter); and Tasmania (1,830 admissions, 538 during winter).

The analysis also found that heart failure hospital admissions cost the Australian healthcare system $334 million in winter – $140 million more than in summer.

Identifying ways to reduce hospital admissions over winter would lead to better health outcomes, as well as deliver considerable savings to health budgets.” said Professor Stewart.

This report will help health authorities plan for an influx of people with heart failure over winter, as well as intensify efforts to winter-proof Australians at risk of heart failure,” he added.

Previous research found that heart failure affects half-a-million Australians, with 67,000 Australians diagnosed each year. By 2025, it is predicted that approximately 650,000 Australians will suffer from the condition, an increase of almost 30 per cent, compared to 2017.



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