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Winter’s deadly reach revealed

Winter is a deadly time for older Australians – and the flu is not to blame.

The prevalence of heart failure is 32 per cent higher during the colder months, according to a new report, Peak Winter! A Report on the Seasonal Impact of Heart Failure in Australia.

It reveals that thousands of older Australians are being hospitalised as temperatures plummet, and that up to 8800 hospital admissions and hundreds of deaths could be prevented.

The report, from the Melbourne and Torrens Universities says, there have been 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 5200 more admissions for heart failure than during summer.

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 8800 admissions.

If those 8800 more admissions due to seasonality were prevented, the health system would save more than $200 million – and hundreds of lives would be saved, the report says

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.

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, the report says.

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 each scored three out of five, Victoria and Queensland two and Western Australia one.

Report author and Torrens University heart failure expert Professor Simon Stewart says: “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 9000 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.

“Even with the best of care, five to 10 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.”

Prof. 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 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.

Professor Louise Burrell, report co-author and Melbourne-based expert in cardiovascular medicine, 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 says.

Prof. Stewart added 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 and 7077 admissions during winter), followed by Victoria (18,900 admissions and 5479 during winter), then Queensland (13,920 admissions, 4066 during winter), Western Australia (7000 admissions, 2019 during winter), South Australia (6100 admissions, 1756 during winter), and Tasmania (1830 admissions, 538 during winter).

Prof. Stewart says the 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”.

Previous research has found that heart failure affects about 500,000 Australians, with 67,000 diagnosed each year. By 2025, it is predicted that about 650,000 Australians will suffer from the condition, an increase of almost 30 per cent compared to 2017.

Were you aware of the impact of colder weather on people with heart conditions? Are you super conscience of your own health during winter?

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