Background

Heart Failure is common in older people (about one in every five older people will develop it) and unlike other cardiovascular problems its prevalence is increasing.

 

In the European Union, the average age of patients with heart failure is 76 years and it affects >5% of people over 65 years and ~20% of octogenarians. heart failure is one of the most common medical reasons for hospital admission, (up to 5% of emergency admissions amongst adults), is associated with damage and dysfunction in many other ‘target’ organs and complicates and is complicated by many other medical problems common in older people, such as renal dysfunction, pulmonary disease, depression, cognitive decline, cerebrovascular disease and malnutrition.

 

Despite advances in care the prognosis remains gloomy once overt heart failure has developed, especially in older patients.

 

Delaying or preventing the onset of heart failure, which has had some success, may be a more effective approach to prolonging active life than trying to manage established heart failure. However, the annual incidence of heart failure is modest even in older people (<3% per year). Only very safe and inexpensive treatments are appropriate for universal treatment.

 

Detection and targeted management of at-risk patients prior to the onset of symptoms is a logical next step, but requires proof.

 

Heart failure and its related co-morbidities are amongst the biggest public health problems in the group of “age-related diseases or disorders affecting the elderly.”

 

The HOMAGE research program aims to fill the therapeutical void by validating BMs that can stratify patients by pathological disease activity in the pre-symptomatic and thus act as a predictor of the onset of symptoms, an early diagnostic marker, a method of predicting outcome and a means of predicting the response to therapy and potentially avoiding unnecessary side effects. This objective is especially important in frail elderly patients who are prone to adverse events, but in whom effective strategies to predict and reduce such events have not been realized.


It is expected that the clinical benefits of a novel and effective therapy for HF would delay the onset or prevent of its progression and then increase quality- (QALY) and or reduce disability- (DALY) adjusted life-years for millions of older Europeans.