National cardiovascular strategy expired two years ago the Irish Heart Foundation tells the Oireachtas

The Irish Heart Foundation has called for the development of a new Cardiovascular Health Policy underpinned by a National Cardiac Register and the urgent implementation of the Stroke Strategy with additional measures to support stroke recovery in the community.

Addressing the Joint Oireachtas Health Committee on Wednesday (16^th of June), Dr Tim Collins, CEO of the Irish Heart Foundation, said that almost 9,000 people die in Ireland every year from heart disease and stroke, and given that 80 per cent of cardiovascular disease was preventable, all but about 1,800 of these lives could be saved, if the right evidence-based policies were put in place.

He said that political will was needed to address the factors fuelling preventable cardiovascular disease – including, overweight and obesity, uncontrolled blood pressure, smoking, physical inactivity, excess alcohol intake and air pollution.

Dr Collins stated that in addition to unnecessary deaths, approximately two million people were at risk, or living with the long-term effects of heart disease and stroke in Ireland.

“No family is left untouched and we’re not doing enough to help them,” Dr Collins said.

While improved treatments, public health measures and awareness campaigns have driven down the burden of heart disease and stroke in past generations, Dr Collins said that the curve was turning on these improvements due to a combination of an ageing population and the impact of lifestyle factors.

Calling for a new cardiovascular policy Dr Collins said, “It sounds extraordinary that for the world’s biggest killer disease, the first thing we need is a plan. The previous national cardiovascular strategy expired two years ago. Not only hasn’t it been replaced, it was never even evaluated.”

“This is even more galling given how neatly a good cardiovascular policy would dovetail with the objectives of Sláintecare. We have a National Cardiac Services Review that has been mothballed by Covid, and a Stroke Strategy focusing on acute services, but we have no overarching framework, and no current intention to create one,” he added.

Dr Collins said that cardiac services faced many severe challenges due to the pandemic coupled with “significant historical service deficits.”

“Chronic heart disease patients make up 44 per cent of Covid deaths and 49 per cent of related ICU admissions in Ireland, whilst the future impact of reductions in heart attack admissions, which peaked at 80 per cent, remains unknown,” Dr Collins stated.

In the absence of a National Cardiac Register Dr Collins said that real-time data was hard to establish however, cardiologists have advised that outpatient waiting times for new patients were as high as 14 months, while waiting times for echocardiograms have lengthened from seven to 12 months in some hospitals, and some patients were waiting for more than a year for an angiogram.

“Cardiologists also report that their patients are generally sicker due to cancelled clinics and reduced GP access. In this information twilight zone, it’s not possible to estimate the impact of Covid-related service deficits on death and disability,” he said.

Dr Collins also stated that stroke services too faced “a bleak outlook.”

“It’s estimated that stroke incidence will increase by 60 per cent in a decade – from around 7,500 to 12,000 a year. But almost four years after the commitment was made to our first national stroke strategy, it remains unpublished,” Dr Collins said.

According to Dr Collins, while the Stroke Strategy addresses deficits in acute services, it does not contain any measures to aid the recovery of stroke survivors living in the community.

“Nothing typifies the neglect of post-discharge services more starkly than the failure to establish how many stroke survivors we have in Ireland. The estimate used by the HSE and Department of Health of 30,000 is based on an estimate that’s almost a quarter of a century old. IPH research and extrapolations from UK statistics suggest the real figure is around 90,000,” he said.

In its submission to the Joint Oireachtas Committee on Health, The Irish Heart Foundation also called for an outright ban on junk food marketing to children as promised in the Public Health Obesity Bill.

The Irish Heart Foundation also called for a ban on e-cigarettes advertising and child friendly flavours, a national hypertension awareness campaign, and action on tackling air pollution which costs 1,500 lives in Ireland every year – mainly due to heart disease and stroke.