BHF gives verdict on heart disease report

“The NSF for CHD demonstrates that if you put enough effort and money into affecting change, you can get real results. But we cannot afford to take our foot off the pedal, as there’s a huge burden of disease out there that still needs to be tackled. We should acknowledge that the NSF has helped us take heart disease care in England forward in leaps and bounds, as was desperately needed six years ago. But despite the continued fall in premature deaths from heart attacks, coronary heart disease remains the UK’s single biggest killer. And the same efforts that have gone into achieving improvements in heart attack care now need to be aimed at all areas of cardiovascular diseases, including stroke and angina.

“With more lives being saved, we also need to improve care for the survivors, for example, by providing equal access to cardiac rehabilitation programmes and, for end-stage heart failure patients, ensuring palliative care is available to all who need it.”

Heart attacks that require treatment with either clot-busting drugs or angioplasty represent a relatively small proportion of the increasing burden of cardiovascular disease in the UK and it is generally accepted that there is still a huge amount to be done. The BHF also believes that it is now time to address all vascular diseases with equal vigour. For example, patients with a threatened heart attack or severe angina may still wait more than a week in hospital before receiving appropriate investigations and treatment. This, says the BHF, is simply too long.

Stroke is the brain’s equivalent of a heart attack, yet most stroke patients receive nothing like the level of care as a heart attack patient. And patients with disease in the arteries of their legs, who are at very high risk of heart attack or stroke, often do not receive appropriate cardioprotective drug therapy. The report highlights a need to address these and other aspects of cardiovascular care that have not so far been the direct focus of the NSF.

Furthermore, with fewer people dying prematurely from heart attacks, the result is more people are living with debilitating heart disease. The BHF believes that greater support must be provided to ensure these people enjoy the best possible quality of life, including better access to cardiac rehabilitation and good quality palliative care. However, while the numbers dying from heart disease have been falling due to advances in treatment, the risk factor trends are not getting any better, and in the case of obesity, it is becoming much worse.

While the BHF acknowledges the economic benefits of switching from branded to generic statins, it is also concerned that patients’ protection from a cardiovascular event is being driven solely by a requirement to achieve the current NSF targets rather than the more challenging targets proposed by the Joint British Societies.

The NSF for CHD has shown how well the NHS can respond if given the necessary guidance and resources. The BHF agrees with the Government’s national director for heart disease and stroke, Professor Roger Boyle, that the best level of care and attention should be available to all patients with cardiovascular disease, regardless of their circumstances or its manifestation.

“The BHF will continue to press for all areas to receive the attention and investment from Government that they need,” added Professor Peter Weissberg.