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UK patients twice as likely to die after heart failure as those in Japan, says research

Patients that suffer from heart failure in the UK are twice as likely to die within six months of being discharged from hospital, when compared with patients in Japan, according to new research.

A study, published in Open Heart, analysed data from 894 UK and 3,781 Japanese heart failure patients, looking at five variables strongly related to prognosis – including systolic blood pressure, serum sodium concentration, age, blood urea nitrogen and creatinine.

They found that heart failure patients in the UK had double the discharge mortality rate, with the results possibly reflecting the difference in outpatient services provided post-discharge, the national diet and attitude towards following medical advice.

The researchers said: ‘Overall, patients in the UK were sicker and in-patient and post-discharge mortalities were greater, suggesting that the threshold for hospital admission was higher.

‘Covariate-adjusted in-hospital mortality was similar in the UK and Japan, but 180-day post-discharge mortality was substantially higher in the UK.’

These findings suggested that ‘the quality of in-patient care might be similar’, with the contributing issues occurring after the patients were discharged from hospital.

The authors wrote: ‘In Japan it is customary for patients with heart failure to be seen in the outpatient clinic within four weeks after discharge, even if the heart failure is not severe, whereas in the UK patients are more likely to be managed in the community by heart failure specialist nurses and primary care physicians.’

They continued: ‘Japanese patients may be more likely to follow medical advice and adhere to their prescribed medication. On the other hand, Japanese doctors generally prescribe much lower doses of medicines than their British colleagues.’

The paper added that the Japanese diet - which includes more rice, salt, fish, and less red meat and wheat - could also be a contributing factor. 

Earliet this month Public Health England launched their Heart Age campaign, which uses an online test to tell patients their risk of suffering a heart attack or stroke and suggests lifestyle changes. 

Readers' comments (6)

  • Id love to know the bmi of the respective groups. Afterload and all that.

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  • Headlines should say: "UK patients ten times as likely to eat pork pies (in massive quantities), smoke and drink excessively as those in Japan"

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  • Japanese patients have to contribute between 10-30% of medical insurance to their health care with costs fixed by the government. they visit their doctor on average 13 x year, smoking rates are 19% but decreasing, they utilise mri and cat scans more . pay costs for hospitals are fixed so accessing emergency care can be difficult and pts may be turned away due to this, once in hospital stays are longer and FU appts are routine post discharge. there is a big problem with over use of the healthcare system by patients with minor illness including the use of ambulance services. life expectancy is the highest in the world. patients are more likely to be compliant with medical care due to cultural differences. GP services are not to the same level as in the uk. patients are far more ill when admitted to a uk hospital. you are not comparing to similar systems but two very different ones.

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  • Different culture, genetics and most of all funding and patient behaviour account for this. In Japan people take responsibility for their health and does not blame the doctor for over eating.

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  • Let’s send all our heart failure patients to Japan, problem problem solved. (Of course, many of them can’t fly there....)

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  • We are far less aggressive in investigating and treating the underlying causes of heart failure in the UK.Most of these patients are over the age of 70 and are essentially treated with palliative intent.Officially of course we are not ageist.As they say in the NHS:a good patient is a dead patient.

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