Patients in clinical trials differ from our routine patients. They have greater motivation. They have met exclusion criteria. Therefore, we need studies to help us understand what happens in the "real world". Survival rate after heart failure overstated, researchers say

One in eight people who suffer from heart failure will be dead within a month, and ne in three will succumb within a year, according to a Canadian study.

Such mortality is almost four times as high as that cited in high-profile clinical trials, suggesting that much research grossly overstates survival rates of patients suffering from cardiovascular disease.

"There continues to be a large treatment gap between what is seen in clinical trials and what is observed in the real world," said Philip Jong, a research fellow at the Institute for Clinical Evaluative Studies and lead author of the research.

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Among patients aged 75 or older, more than 40 per cent died within one year of first experiencing heart failure.

When the patients had other ailments, mortality rose sharply: 61 per cent of men and 56 per cent of women were dead within one year.

In contrast, only 14 per cent of heart-failure patients aged 50 or less were dead within one year of their initial hospitalization.

"This is a wake-up call that we need to treat elderly patients with heart disease as effectively as we do younger patients," said Peter Liu, a cardiologist at Toronto General Hospital and co-author of the study. "We need to conduct additional studies in the elderly population to find safe and effective treatment strategies for this group of patients."

Jack Tu, an internist and a senior scientist at ICES, said that physicians and patients need to recognize the seriousness of heart failure.

"The prognosis for elderly heart-failure patients is worse than many cancers."

Dr. Tu said the research suggests that many older patients need to be treated more aggressively, and that more research is required to find new therapies.

I would submit that younger patients less often have multiple confounding diseases. Our older patients may not respond as well to medical therapies. They may not take their medications as well. Or we may not prescribe as aggressively. Interesting data presented here - the article comes out in the Archives of Internal Medicine today.