Improved management of risk factors after stroke and heart attack could save over a million lives in EU

While overall mortality rates from cardiovascular disease have improved over the last two decades, progress has plateaued
- Jennifer Gill
Man clutches chest. Tumisu from Pixabay

Over one million fatal heart attacks and strokes could be prevented across the European Union, plus 130,000 in the UK, over the next ten years with better management of the key risk factors facing people with pre-existing heart disease, says a report by LSE, commissioned by the European Federation of Pharmaceutical Industries (EFPIA).  

These deaths could be avoided if 70 per cent of people living with cardiovascular disease (CVD) had their high cholesterol, high blood pressure, high blood glucose and smoking better managed, while also eating healthier diets and undertaking more physical activity.

Researchers looked at the impact of improving these CVD secondary prevention measures in France, Germany, Italy, Spain, Denmark, Poland and the UK.

Dr Jennifer Gill, Associate Director at the Medical Technology Research Group at LSE and one of the authors of the report said: “While overall mortality rates from cardiovascular disease have improved over the last two decades, progress has plateaued. Reversing this is essential because many people who have suffered from a CVD event are highly vulnerable and are likely to go onto experience an often fatal heart attack or stroke.”

Cardiovascular disease is the number one killer in the UK and costs the economy as much as six per cent of the NHS’ budget.

Across the EU, CVD costs €282 billion a year and is responsible for 65 per cent of the avoidable deaths that occur in the working age population.

Nathalie Moll, Director-General of EFPIA said: “There is a huge opportunity to address reversible risk factors in people who are already living with CVD. If existing evidence-based treatment targets and recommendations are followed, the impact will be profound.” 

Recommendations to improve secondary CVD prevention

Joint cardiovascular and diabetes health checks would be a cost-effective way to improve the early diagnosis of both diseases.

Development of a European Cardiovascular Health Plan. A political push is needed to implement proposals by the European Alliance for Cardiovascular Health (EACH) focusing on: primary prevention; secondary prevention; early intervention and treatment; rehabilitation and; improved quality of life for survivors.

All 27 EU member states should develop, implement and fund national Cardiovascular Health Plans to ensure access to CVD related healthcare and so reduce inequalities in CVD prevention and treatment across the EU.

Establish equitable access to prevention across the EU by ensuring all countries follow standardised treatment guidelines enabling patients to reach their targets for blood pressure, cholesterol and glucose.

Better data collection across the EU to allow for more accurate estimates of the success of optimised secondary prevention and calculation of cost benefits.

Design the right healthcare system incentives in primary care to achieve effective CVD management. Incentives such as key performance indicators and pay-per-performance schemes may help increase the proportion of patients reaching their treatment targets for CVD risk factors.

Encourage provision of effective rehabilitation programmes. These prevent the recurrence of heart attack, stroke or heart failure and improve recovery and survivor well-being. 

Build health literacy progammes which reduce the prevalence of CVD risk factors by showing people how to improve their own ‘self- care’ and encourage them to adhere to their medication regimens.


Behind the article

How can we Improve Secondary Prevention of Cardiovascular Disease? By Jennifer Gill, Aurelio Miracolo, Konstantina Politopoulou, Sahan Jayawardana, Alex Carter, Efstratios Apostolou and Panos Kanavos.