Iron key to heart failure patients’ wellbeing
Patients with chronic heart failure should be made aware of the importance of having their iron levels checked regularly, with research showing half of all heart failure patients have low iron, increasing their risk of hospitalisation, which is often associated with premature death.
More than half a million Australians have chronic heart failure, and it is estimated that around 158,000 will require hospitalisation each year.
Hospitalisation for heart failure is associated with high rates of readmission, and death, with Australia recording an estimated 61,000 heart failure-related deaths each year.
New Australian treatment guidelines recommend intravenous iron treatments rather than oral supplementation for patients with heart failure with reduced heart function who have low iron.
This is in a bid to reduce the risk of hospitalisation, as oral iron has been shown to be ineffective in increasing iron levels in these patients.
The updated guidelines reflect new research, including a 2020 study that found heart failure patients that received an intravenous iron treatment had a 26 per cent risk reduction in total heart failure hospitalisation, and were 21 per cent less likely to experience cardiovascular death and total heart failure hospitalisation.
University Hospital Geelong cardiologist John Amerena, who co-authored the new treatment guidelines, said iron deficiency was easily diagnosed by a blood test, and should be screened for as part of routine management for heart failure patients.
“Patients with heart failure with reduced heart function can experience symptoms of tiredness, restlessness, bloating and poor quality of life.
These can occur regardless of whether the patient is anaemic or has experienced iron deficiency in the past,” Associate Professor Amerena said.
Heart failure prevents the heart from pumping enough blood to organs and tissues and can occur as the result of conditions such as coronary artery disease, high blood pressure, heart valve defects, viral infection, or alcohol misuse.
Associate Professor Amerena said heart failure patients’ chances of survival decreased with each subsequent hospitalisation, with research showing a 25 percent chance of death within one year of first hospital admission.
He said evidence showed intravenous iron could improve symptoms and patient quality of life, helping to prevent rehospitalisation.
Women were more typically at risk of low iron, particularly before menopause, and should have their iron levels measured regularly, particularly if they had a history of heart problems or their family members had experienced heart issues, he said.
“Women should be aware that low iron is common in heart failure. Measuring iron levels should be a part of routine blood testing. If their iron stores are low, there is good evidence that the administration of intravenous iron can improve their wellbeing and functional status, as well as reducing the risk for re-hospitalisation” he said.
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