Today in the UK around 480 people will go to hospital with a heart attack. About seven in ten will return home. In the space of a generation, pioneering research has transformed the way in which we care for victims of heart attacks, paving the way for life-saving treatments. The odds of survival and recovery have improved beyond recognition.
But cardiovascular disease – heart conditions and stroke – still kills around one in four of us, and takes the lives of more than 100 people in the UK every day. Many of those who survive a heart attack or stroke suffer from a decline in their quality of life through disability and their life expectancy is reduced.
The World Health Organization (WHO) has set a target to reduce mortality from four major preventable diseases – diabetes, cancer, chronic lung disease and cardiovascular disease – by 25 per cent by 2025, against 2010 levels. The UK government has formally signed up to this target and has made a commitment to take strong action at all levels to ensure it is met.
The WHO programme on cardiovascular disease is run in partnership with the World Heart Foundation, which is tasked with monitoring progress and ensuring best practice is openly shared to inform global public health policy.
There are an estimated seven million people in the UK living with cardiovascular disease, divided almost equally between men and women. An ageing and growing population, and improved survival rates from cardiovascular events, will see this number rise further. If the UK succeeds in meeting the WHO target, it would save 10,500 more lives each year.
Three quarters of cardiovascular disease is preventable. There are big gains to be made through health education and raising awareness of the risks. This means empowering people to make healthy choices related to physical inactivity, smoking, high blood pressure, elevated cholesterol and obesity that reduce the risk of cardiovascular disease.
There are big gains to be made through health education and raising awareness of the risks
There is an urgent need to reduce the number of people who smoke or live with undiagnosed high blood pressure or high cholesterol, with a particular focus on people and communities at highest risk of heart disease.
Preventing cardiovascular disease is also about helping to create a sustainable NHS. The health service is struggling to contain costs, which are increasing by about £5 billion a year, partly because of the increase in demand for care from patients with long-term conditions.
Cardiovascular disease wreaks havoc on individuals and families’ lives, but is also a blight on the wellbeing of communities, and increases deprivation and inequality. People with cardiovascular disease live shorter lives and live a greater proportion of their lives with disability. In the most deprived communities more than a quarter of adults smoke and are at greater risk of cardiovascular disease and premature death.
Earlier this year, The Richmond Group of charities published a report, entitled The PROMISE Study, into how the UK can achieve the 25 x 25 goals set by the WHO. The Richmond Group is a coalition of 12 leading health and social care organisations in the voluntary sector. Its members include the British Heart Foundation, Stroke Association and the British Lung Foundation. Their view is that the targets are not ambitious enough for the UK, given the country’s wealth and the quality of our healthcare system.
It is disappointing that The Richmond Group has warned that the UK risks missing its WHO targets unless urgent new action is taken.
The PROMISE Study found that, if current trends continue, we should see 25 per cent early deaths in women and 22 per cent in men in the UK. Achieving the WHO goals would delay or avert around 250,000 deaths (161,000 deaths in men, 89,000 in women). It would also prevent around 1.12 million years lived with disability (630,000 in men and 490,000 in women); in other words, 1.12 million people having one extra year of healthy, disability-free life.
A number of interventions are needed if the UK is to make the required progress towards the 25 x 25 goals and beyond. The Richmond Group welcomes the introduction of the sugar tax, but calls for bolder steps in food reformulation to reduce salt and sugar content as well as portion size. It also seeks a further increase in tobacco tax of around 5 per cent above the level of inflation and restrictions on alcohol marketing. The group further recommends that health professionals, including GPs, should openly advocate the need to increase physical activity, to help bring about the required change.
With increasing pressures on the NHS and social care, we need look after our own health better. Individuals, families and communities must be supported and enabled to take action. But providing information alone is not enough to create the scale of change needed to prevent unnecessary illness. We need action to tackle the underlying causes and motivations of harmful behaviour, and create an environment in which people can more easily make healthy choices around food and drink, be more active, and not smoke.
Public services, business, charities and government have a vital role to play in improving health, preventing long-term conditions and avoidable deaths. World Heart Day is an opportune moment to reflect on what is at stake and what remains to be done.