A disturbing legacy of long waiting lists and sedentary lifestyles, writes professor of cardiovascular medicine Chris Gale
It is very disappointing to hear that the number of people dying from coronary heart disease and heart failure in Britain is rising – not least because these conditions are preventable and treatable, with a good prognosis.
The latest figures show that the death rate from heart disease is at its highest level in more than a decade, which is worrying, especially as it has been falling for years before that trend started to change in 2012.
Last year was the deadliest non-pandemic year for excess deaths since 1945, and the biggest increase was for heart failure (where the heart is unable to pump blood efficiently), with a shocking 16 percent year-over-year increase. Heart failure was responsible for almost 10,000 additional deaths.
This is despite the availability of effective therapies such as ACE inhibitors, diuretics, beta blockers and more recently SGLT2 inhibitors for diabetes (a major risk factor for heart disease) and heart failure.
Although my clinic is treating patients quickly, the waiting list for cardiac care across England is 72 percent larger than in February 2020 (photo, Professor Chris Gale)
People live longer and are more likely to develop heart disease and other health problems (stock photo)
Together, these medications reduce symptoms and increase life expectancy. We can only speculate about the reasons for this increase, but in a more positive light it is possible that it reflects the fact that we have better diagnostic tests for heart disease and heart failure.
Another factor is that cardiac patients today tend to be older, reflecting our aging population.
People live longer and are more likely to develop heart disease and other health problems.
And more people are surviving heart attacks – my research has shown that survival rates ten years ago were double those of twenty years ago – thanks to better awareness of the symptoms and rapid care in specialist units.
This is good news, even though many of these patients will develop heart failure.
All this said, there are serious issues affecting healthcare that could accelerate the rise in cardiovascular disease deaths – including waiting lists for heart specialists like me, which are unacceptably high.
Other factors include our increasingly sedentary lifestyle and poor eating habits, high in saturated fat, sugar and salt, which increase the risk of cardiovascular disease later in life (stock image)
High blood pressure is a major risk factor for heart disease, but often shows few or no symptoms until it causes a heart attack or stroke (stock image)
Although my clinic is treating patients quickly, the waiting list for cardiac care across England is 72 percent larger than in February 2020.
This is an increase of 169,000 people – enough to fill Wembley Stadium almost twice over. The longer people wait for treatment, the greater the risk that they will become disabled by heart failure or die prematurely.
The ambulance service is also not working as well as it should: the average ambulance response time in England for Category 2 calls – including suspected heart attacks and strokes – was 46 minutes in December, down from 39 minutes in November.
Remote GP consultations are a real help in many ways, but they can make it more difficult for people to keep up with their blood pressure checks, which would normally happen with in-person appointments.
High blood pressure is a major risk factor for heart disease, but it often shows few or no symptoms until it causes a heart attack or stroke.
Other factors include our increasingly sedentary lifestyle and poor eating habits, high in saturated fat, sugar and salt, which increase the risk of cardiovascular disease later in life.
More needs to be done in education and making it easier for people to make healthier choices within their budget so they don’t develop heart disease in the first place.