Professor Lale Tokgozoglu
In the run up to the “Putting the Heart First: Closing the Gaps in European Cardiovascular Care" event, On Tuesday 10 October, organised in association with the Parliament Magazine and with the support of Amgen, Professor Lale Tokgozoglu argues that early action and aggressive implementation of prevention and control plans could reduce Europe’s cardiovascular disease epidemic.
The global burden of disease has dramatically shifted from communicable to non-communicable diseases, making cardiovascular disease the leading cause of death in Europe as well as most parts of the world.
Unless action is taken, even with the most optimistic WHO predictions, it will continue to be the number one killer in 2030.
There are more than 11 million new cases of cardiovascular disease in Europe of which six million are in the EU.
In addition, cardiovascular disease accounts for 45 per cent of all deaths in Europe and 37 per cent of all deaths in the European Union. It is the main cause of the death in men in all but 12 European countries, and in women in all but two countries.
It is well known that cardiovascular disease is the leading cause of death in high per capita income countries. However, 80 per cent of the cardiovascular deaths are from low and middle income countries globally, and half of them are women.
Europe is in the midst of an epidemiologic, economic, social and nutritional transition. The past few decades have shown that Europe and especially low and middle income countries have undergone rapid industrialisation, urbanisation, economic development and market globalisation.
Although these developments have led to many positive changes in health outcomes and increased life expectancies, they have also caused inappropriate dietary patterns, physical inactivity and obesity. Fat and energy consumption is increasing mostly in Eastern Europe and smoking remains a key public health issue despite its decline in some countries.
There are strong geographical disparities across Europe. Eastern and central European countries have higher rates of cardiovascular mortality than Northern, Western and Southern Europe.
The past 30 years have seen a decline in age adjusted cardiovascular mortality in most Northern and Western European countries. This change has been less consistent in Central and Eastern Europe.
"With almost 49 million people with cardiovascular disease in the EU, the economic cost is high at €210bn per year"
With almost 49 million people with cardiovascular disease in the EU, the economic cost is high at €210bn per year. When we look at the percentage of total health care expenditure on cardiovascular disease, more than half of the resources goes to inpatient care and about a quarter to medications.
Unfortunately, primary care gets a small percentage despite the fact that prevention is much more important and cost-effective than treatment. Cardiovascular disease can be prevented or postponed by effective prevention policies.
Cardiovascular disease occurs due to preventable or treatable risk factors such as high blood pressure, high cholesterol, diabetes, smoking and obesity. In addition, lifestyle, socioeconomic and environmental conditions have a huge impact on the disease’s development.
In Europe, the most important contributors to the burden of cardiovascular disease are high blood pressure, high total cholesterol, high body mass index and dietary risk factors, smoking and high blood sugar.
We also know that socioeconomic deprivation increases the dependence on alcohol and tobacco use as well as leading to the consumption of unhealthy foods. When we look at rankings of European countries according to GDP per capita we see that cardiovascular risk goes hand in hand with low income.
There is strong evidence showing that it is possible to reduce cardiovascular disease by simply controlling the major risk factors. There are success stories in some countries in Europe such as Finland where they reduced cardiovascular disease mortality significantly just by controlling smoking, blood pressure and cholesterol.
The WHO has put together a global action plan for the prevention and control of noncommunicable diseases. The goal is to reduce the risk of premature noncommunicable disease deaths by 25 per cent by 2025.
"Prevention of cardiovascular disease needs to be the priority by creating health promoting environments, strengthening the national capacity, people centered primary healthcare and universal health coverage as well as high quality research in the field"
According to this plan, reduction in tobacco use, salt intake, physical inactivity, harmful use of alcohol, raised blood pressure as well as stopping the diabetes and obesity epidemics are the goals.
Prevention of cardiovascular disease needs to be the priority by creating health promoting environments, strengthening the national capacity, people centered primary healthcare and universal health coverage as well as high quality research in the field.
Early action and aggressive implementation of this plan may reduce the cardiovascular disease epidemic if the individual WHO targets are met and healthcare systems are strengthened with partnership across countries and different sectors such as healthcare providers, cardiac societies, healthcare authorities and the EU.
Click on the link to register to attend and join Professor Lale Tokgozoglu at the event on “Putting the Heart First: Closing the Gaps in European Cardiovascular Care" nosted by MEPs Pavel Poc and Karin Kadenbach