Half a Million Dutch People Suffer from Heart Failure Without Knowing It: Recognizing Atypical Signs Saves Lives

Heart failure affects approximately 500,000 people in the Netherlands, though estimates from Dutch health organizations indicate that more than half of those individuals remain unaware they have the condition.

Public health officials emphasize that early recognition of symptoms is critical, as it can prevent premature death and hospitalization.

Research from the Hartstichting (Dutch Heart Foundation) confirms that general knowledge regarding heart failure is limited and that many people underestimate the severity of the disease. According to Hans Snijder, director of the Hartstichting, the public’s perception of heart failure does not align with reality, leading many to wait when experiencing symptoms rather than seeking the early recognition and treatment necessary to prevent the condition from worsening.

The Role of the PLN Gene Mutation

Some cases of heart failure in the region are linked to a specific genetic mutation involving the PLN gene. Dr. Charles Hong, a professor and chair of the department of medicine, describes the PLN gene as acting like a dimmer switch for the heart, which helps regulate its contraction.

Experts believe this mutation originated centuries ago in Friesland, a province of the Netherlands, and has been passed down through generations. For individuals carrying this mutation, Dr. Hong states that the dimmer switch is always off.

The mutation is linked to sudden cardiac death and heart failure, typically manifesting when a person is in their 30s, 40s, or 50s. While symptoms can include dizziness and shortness of breath, Dr. Hong notes that individuals may still be at risk even if they exhibit no symptoms.

Screening and Risk Factors

Because the majority of people with this genetic condition are likely unaware they carry the mutation, medical experts recommend targeted testing for high-risk individuals.

Dr. Hong suggests that a consultation with a cardiologist for testing is advisable for individuals who meet the following criteria:

• Having a first-degree relative, such as a parent or sibling, who developed heart failure without a known cause.
• Having a first-degree relative who died unexpectedly and suddenly, typically around their 40s or 50s, without a known cause.

Heart Failure Research in the Netherlands

The Netherlands has a long-standing history of multicentre research into heart failure, with the first trial conducted in 1993. Dutch institutions continue to maintain a leading role in both national and international studies.

Current management and research efforts in the country focus on several key areas, including:

• The use of SGLT2 inhibitors.
• Nutrition and the use of diuretics.
• The implementation of home monitoring systems.