Age related diseases including coronary artery disease and heart failure are still major health concerns in the UK, despite the fact that they are both preventable and treatable.
The latest figures show that In the UK, one in eight men and one in 14 women die from coronary heart disease. Living with heart failure is becoming increasingly common. Around 920,000 suffer from heart failure and there are 200,000 new cases annually in the UK, due to an ageing population and improved survival rates after a heart attacks.
This is worrying, especially as the death rate for heart disease was in decline for many years, before that trend started to change in 2012.
2022 was the deadliest non-pandemic year for excess deaths since 1945, and the largest rise was for heart failure. This is despite the availability of effective therapies such as ACE inhibitors, diuretics, beta blockers and more recently SGLT2 inhibitors for diabetes, which is a major risk factor for heart disease. Together these medications reduce symptoms and increase life expectancy.
Looking at this positively, it could reflect that we have better diagnostic tests for heart disease and heart failure, such as blood tests that look for BNP (brain naturistic peptide), an enzyme released by the heart into the bloodstream – raised levels are a sign of damage.
But another factor is that heart patients tend to be older these days, reflecting our ageing population. People are living longer, and they are more likely to develop heart disease as well as other health problems. And more people are surviving heart attacks – my research has shown that survival rates 10 years ago were double those of 20 years ago. This is thanks to better awareness about symptoms and rapid care in specialist units. This is good news, but many of these patients will go on to develop heart failure.
ALL THIS said, there are still serious important issues affecting the health service which may be accelerating the rise of heart disease deaths – including waiting lists to see heart specialists like me, which are unacceptably high.
While my clinic sees patients rapidly, the longer people wait for treatment, the higher their risk of becoming disabled from heart failure or dying prematurely.
Remote GP consultations are a real help in lots of ways, but they may make it harder for people to keep on top of their blood pressure checks – which would have been routinely done at face to face-to-face appointments. High blood pressure is a major risk factor for heart disease, but it often has few or no symptoms until it causes a heart attack or a stroke.
Other drivers include our increasingly sedentary lifestyles and poor diets, with lots of saturated fat, sugar and salt, which raise the risk of cardiovascular disease later in life.
The author is Professor Chris Gale, professor of cardiovascular medicine and Co-Director of the Leeds Institute for Data Analytics at the University of Leeds.
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