Heart disease rates are declining, but not fast enough

17 May 2019

Image: Pixabay

Glasgow has highest premature death rates from heart disease in UK

Glasgow has the worst premature death rates from heart and circulatory disease in the UK, a new British Heart Foundation report reveals.

The city has higher death rates than both Manchester and Blackpool, with 144 per 100,000 of the population of Glasgow suffering an early death from heart disease.

A National Statistics report published in January similarly found that the decline in heart disease mortality rates in Scotland has slowed in the last five years.

Dr David Murdoch, Heart Disease Managed Clinical Network lead for Greater Glasgow and Clyde, said: “Unfortunately Glasgow has always had the worst rates for premature death from heart disease which cannot be fully explained by demographics or risk factors, the so-called ‘Glasgow effect’.

“Rates have however declined over the years in line with other parts of the UK, although the gap has persisted. The rate of decline in the last few years has slowed and there is an increase in the incidence of cardiovascular disease particularly in the most socioeconomically deprived sections of the population.”

Kylie Strachan, British Heart Foundation’s Senior Policy and Public Affairs Manager for Scotland, said: “We know that health inequalities persist and are reflected in heart disease rates.

“For example, death rates for premature deaths from heart and circulatory disease are more than three times as high in some of the most deprived areas of the country, compared to some of the most affluent.”

Infographic: Jacob Nicol

The new British Heart Foundation report reveals that the last five years have seen the first sustained rise in the number of premature deaths from heart and circulatory disease in the UK since the 1960s.

Strachan said: “We’ve made phenomenal progress in reducing the number of people who die of a heart attack or stroke each day. But these figures show a worrying and unnecessary slowdown in the pace of progress.

“The reasons behind this are complex but it is likely that uncontrolled and undiagnosed risk factors (like high blood pressure, diabetes and obesity) and stark inequalities could lead to a continuing rise in deaths among younger people.”

Dr Gerry McCartney, Head of the Public Health Observatory at NHS Health Scotland, said: “Whilst there are likely to be a number of factors at play, the recent change in this trend is most likely to be due to the impact of austerity and pressures on health and social care services.”

In Scotland, the rate of heart and circulatory disease deaths before the age of 75 has fallen 77% since 1971.

However, the rate of improvement in premature death rates has slowed significantly in the last five years, falling just 9% between 2012 and 2017, compared to 25% between 2007 and 2012.

Murdoch said: “We have seen an increase in relatively young 55-65 year old patients with multi-morbidity, mainly obesity, diabetes and high blood pressure, which are major risk factors for heart disease.”

The British Heart Foundation report advocates for a combination of more scientific research and better standards of care for those more at risk of heart disease over the next decade.

Strachan said: “Whilst it’s important to consider local issues, what we also require is a national conversation: one that that is collaborative with Government, clinicians, patients and the third sector working together to deliver a heart disease strategy for Scotland that is ambitious, forward thinking and built on breakthroughs.”

Murdoch said: “We now have access to some very advanced therapies for heart disease, but I think the biggest game changer in my career has been the decline in smoking, which required government regulation.

“I think in the NHS we can still improve the efficiency of our diagnosis and treatment of heart disease, but the current challenges of obesity and alcohol will require intervention at national Government level.”

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