A profile of heart failure in the James and Hudson’s Bay region of Ontario: A retrospective cohort study

OBJECTIVES: The James and Hudson Bay (JHB) region in Northern Ontario is home to an estimated 12,000 people; the majority are Mushkegowuk Cree. To better respond to cardiovascular needs in the region and leverage existing partnerships between the Weeneebayko Area Health Authority's Minomathowin Department, ICES, and University Health Network, this study aimed to profile confirmed and possible heart failure (HF) prevalence among community members. METHODS: A retrospective cohort design, using administrative databases housed at ICES, identified community members with possible and confirmed HF as of March 31, 2023. The eligible population included individuals alive, < 105 years of age, and living in the JHB, based on postal code. Confirmed HF cases were identified from the ICES-derived Congestive Heart Failure cohort. Possible HF was defined as the presence of HF risk factors consistent with Canadian Cardiovascular Society guideline definitions. The use of cardiovascular diagnostic tests, notably natriuretic peptide, was also explored. RESULTS: Of the 9495 community members who met eligibility criteria, 144 (1.5%) had confirmed HF and 993 (10.5%) met the definition of possible HF. During routine care, the use of HF diagnostic biomarker testing (brain natriuretic peptide) was low in both confirmed (17.4%) and possible HF (5.6%) cohorts when compared to measurement of potassium, hemoglobin, sodium, or creatinine testing. CONCLUSION: This study identified a significant proportion of possible and confirmed HF cases among community members residing in JHB. The findings underscore a critical need for screening and referral pathways, earlier intervention, and optimization of HF care.