Cardiovascular disease (CVD) is a leading cause of death despite nearly 80% of premature CVD being preventable

A report launched today by the National Institute for Prevention and Cardiovascular Health (www.nipc.ie) and the National CVD Prevention Council (NIPC and the Irish Heart Foundation) has identified gaping holes in Ireland’s cardiovascular healthcare. The report outlines that cardiovascular disease (CVD) kills nearly 9,000 in people in Ireland every year, despite an estimated 80% of premature CVD being preventable.

Dr Angie Brown, Medical Director of the Irish Heart Foundation said: “We face a groundswell of rising CVD risk factors from population ageing, obesity, to new environmental threats from climate change. These challenges will result in a growing burden of disease and pressure on our healthcare system. To avoid this, we must identify any gaps in CVD prevention and management and ensure all patients requiring services to treat CVD should have access to timely, preventive care through the development of an annually reviewed national strategy that supports our health care system whilst saving lives.”

While there is a myriad of gaps in how the Irish healthcare system detects signs of CVD, notable issues include Ireland having the lowest rate of detection of high blood pressure in Western Europe.

This is particularly worrying when considering that in 75% of those that had a heart attack between 2017-2020, the heart attack was the first manifestation of CVD. Likewise, more than 1,200 people that suffered an ischaemic stroke in 2020 were found to also have atrial fibrillation (AF), a common type of irregular, usually rapid, heartbeat. However, AF was not identified in 40% of patients until they suffered the stroke.

The report recommends a screening program for familial hypercholesterolaemia (FH), a genetic condition which causes dangerously high cholesterol levels from birth. FH affects around 1 in 200-250 people in Ireland however the majority of this goes undetected. Childhood FH screening programmes are commonplace throughout Europe.

The report also details issues in the treatment and discharge of patients following the detection of CVD. These issues include long waiting times in public hospitals and the lack of tailored discharge plans for patients.

Access to cardiac rehabilitation is paramount to the recovery of those post-cardiac events yet it has significantly declined. A 2017 study previously identified that there was national capacity to meet only 39% of the need for cardiac rehabilitation while in 2021 there was a waiting list of more than 2,800 people, with 40% waiting at least three months following hospital discharge.

The issues in the management of patient discharges are particularly worrying when considering that in the absence of Irish data, the report references a Swedish study which reveals that nearly 20% of people that suffer a heart attack die from a cardiovascular cause or experience a repeat heart attack or stroke within a year.

In response to the urgent needs identified by the report, NIPC and the National CVD Prevention Council is calling on the Government to develop a national strategy to tackle cardiovascular disease (CVD). The previous national strategy expired in 2019 and has not been replaced.

The implementation of electronic health records is identified as a critically important key to integration of services required for effective prevention in clinical practice.

The report also outlines the requirement for investment in data collection and analysis to inform the strategy, the need to expand the role of nurses and allied health professionals and to increase access and care to disadvantaged groups.

Speaking at the launch of the report, NIPC’s Research & Medical Director, Prof Bill McEvoy said:
“We know that there is real ambition to transform the Irish healthcare system. With Ireland’s ageing population, making the prioritisation of CVD prevention part of that transformation is more important than ever. The lack of a national strategy for what is society’s greatest killer is a significant and worrying gap. CVD is a preventable disease, yet it kills nearly 9,000 people per year. We have previously demonstrated national leadership in the space through lasting actions such as the smoking ban; we now need to recognise that more needs to be done to tackle CVD.”

The Advancing a Prevention Agenda for Cardiovascular Care in Ireland report is an initiative of the National Institute for Prevention and Cardiovascular Health (NIPC) in partnership with the National CVD Prevention Council.
To read the report, please visit: https://nipc.ie/national-prevention-council-report-2023/