Heart failure: biggest cause of hospitalization in the SUS – 10/02/2024 – Equilíbrio e Saúde

Heart failure is the condition that causes the most hospitalizations in SUS (Unified Health System) hospitals and emergency rooms in the country, compared to other heart diseases.

This is what a survey by Abramede (Brazilian Association of Emergency Medicine) says, from January to July 2024, based on data from the SIH (Hospital Information System) of the SUS. Of the 113,514 hospitalizations for this reason, 93.3% occurred in emergency services.

The numbers were presented at the Brazilian Congress of Emergency Medicine, held from September 24th to 29th, in Campo Grande (MS).

Acute myocardial infarction comes next, with 102,659 hospitalizations, followed by other ischemic heart diseases (85,520), and conduction disorders and cardiac arrhythmias (46,761). The sum of all causes —376,403— represents 58.6% of the entire year 2023, which ended with 641,980 hospitalizations.

Like last year, in 2024, hospitalizations for heart problems in emergency services will be the majority, 82.7% (311,598) of the total.

According to Camila Lunardi, president of Abramede, heart failure occurs when the heart is unable to pump blood efficiently, requiring emergency intervention to avoid serious outcomes. The biggest cause of this condition is the complication of a heart attack. The others are uncontrolled hypertension and diabetes, in addition to some diseases associated with changes in the heart muscle.

“These are patients who did not receive good treatment for their heart attack during the first few days, or did not adhere to good treatment post-infarction. And then the patient ends up with this chronic condition. He becomes a person with heart failure and all the Sometimes this insufficiency decompensates, the patient needs to go to the emergency room”, explains Lunardi. Chest pain, shortness of breath, swollen legs and feet are some signs.

Low blood pressure, cholesterol and diabetes levels, physical activity, healthy eating and medication use keep the disease under control.

Looking at the regions of the country, the Southeast concentrated the highest absolute number of hospitalizations for heart disease — 168,611. The states of São Paulo (82,775) and Minas Gerais (50,980) lead.

In the Northeast, Bahia (21,465) and Pernambuco (15,926) have the highest numbers. In the North, Pará (7,038) and Amazonas (5,165) appear. In the South, the highlight is Paraná (33,510) and in the Center-West, Goiás (12,987).

São Paulo and Belo Horizonte are the capitals with the highest absolute numbers of hospitalizations — 22,592 and 11,179, respectively. Together, the federations total 128,696 hospitalizations for heart disease. Of these, 76% refer to emergency services. In this section, the most critical scenarios are in the Federal District (96.2% of the total), Ceará (95.5%) and Mato Grosso do Sul.

Camila Lunardi highlights that, in addition to being stressful, the lifestyle in large cities is less healthy. The option for fast eating, little time for physical activity, relaxation, meditation and moments of tranquility contribute to high heart attack rates.

“We are living in a time when the aging of the population and the increase in risk factors, such as a sedentary lifestyle and poor diet, have led to an increase in cases of heart disease”, explains Lunardi.

Regarding the profile of patients, the age group that concentrates the most hospitalizations for heart problems, in both sexes, is 60 to 69 years old — men represent 60.8% of those hospitalized, and women, 39.1%.

According to the expert, men are more resistant to preventive treatment for cardiovascular diseases. Genetic predisposition is another factor that explains the higher percentage of males.

“Men have greater cardiac non-protective factors than women, such as testosterone. Factors associated with the male sex, non-adherence to treatment and, often, the carelessness of only seeking a doctor when they feel unwell , when they have chest pain, it is also most associated with the fact that they have more heart attacks”, says Lunardi.

“To live well, my biggest advice is to prevent, based on a healthy quality of life. People who already know that they are hypertensive, diabetic and have high cholesterol should carry out strict control. Those prone to developing these diseases should have a diet healthy, do physical activity, have good quality sleep. I think these are the main points for trying to reduce the number of patients arriving at emergency rooms”, advises the specialist.

According to Lunardi, the mapping also shows the urgency and importance of emergency doctors, who are on the front line of critical situations. “This is one of the many challenges we face every day. Therefore, it is essential to strengthen hospital infrastructure and continually train emergency teams to deal with the growing volume and complexity of cases”, he concludes.

_{This project is a partnership with Umane, an association that supports public health initiatives.}