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Heart failure beyond city limits

by Geraldine Hinter

Stethoscope and chartsDeaths from chronic heart failure are up to 50 per cent higher in rural and remote areas than in major cities.

While the number of people with chronic heart failure (CHF) is highest among people living in cities, a disproportionate number of people with CHF live outside of cities, where there are often fewer and less accessible services, according to UniSA researcher Robyn Clark.

A PhD scholar supported by the National Institute of Clinical Studies and the National Heart Foundation of Australia, Clark has been studying CHF population estimates in three geographical areas – capital cities, large urban centres, and rural and remote regions.

"CHF has reached epidemic proportions in Australia and is particularly significant for older people, men and Indigenous people. These groups make up a greater proportion of the population in rural and remote Australia," Clark said.

In most states and territories, the prevalence of CHF is highest in rural and remote regions and large urban centres. This is particularly so in idyllic rural locations favoured by retirees.

Of the 62 CHF medical centres in existence throughout the study, 58 were in highly accessible areas, with no centres outside of large urban sites.

This means the large majority of Australians with chronic heart failure are not managed by CHF specialists, according to UniSA’s Chair of Cardiovascular Nursing, Professor Simon Stewart, who is supervising Clark’s research.

"There is an urgent need to reconsider the way in which CHF is managed across Australia, with different strategies needed in different states and regions," Prof Stewart said.

"One solution would be to establish satellite centres for heart failure management in rural and remote regions."

While the Heart Foundation’s Chat Study gives some CHF patients from rural and remote areas access to online support from cardiac specialists by telephone, Prof Stewart is keen to see patients from remote areas fitted with heart monitors that feedback information to cardiac specialists.

"This would enable heart failure management specialists to quickly assess a patient’s condition and ensure early intervention. Most importantly, it will save lives," Prof Stewart said.