A troubling legacy of long waiting lists and sedentary lifestyles

IT IS very disappointing to hear that the number of people dying from coronary artery disease and heart failure is on the upturn in the UK – not least because these conditions are preventable and treatable, with a good prognosis.

The latest figures show that the death rate from heart disease is at its highest level in more than a decade, which is worrying, especially as it was in decline for many years, before that trend started to change in 2012.

Last year was the most deadly non-pandemic year for excess deaths since 1945, and the largest rise was for heart failure (where the heart is unable to pump blood efficiently), with a shocking 16 per cent jump year on year. Heart failure was responsible for almost 10,000 excess deaths.

This is despite the availability of effective therapies such as ACE inhibitors, diuretics, beta blockers and more recently SGLT2 inhibitors for diabetes (a major risk factor for heart disease) and heart failure.

Together, these medications reduce symptoms and increase life expectancy. We can only speculate about the reasons for this rise but, in a more positive light, it is possible that it could reflect the fact that we have better diagnostic tests for heart disease and heart failure.

Another factor is that heart patients tend to be older these days, reflecting our ageing population. People are living longer and they are more likely to develop heart disease, as well as other health problems.

And more people are surviving heart attacks – my research has shown that survival rates ten years ago were double those of 20 years ago – thanks to better awareness about symptoms and rapid care in specialist units. This is good news, even though many of these patients will go on to develop heart failure.

All this said, there are serious issues affecting the health service which may be accelerating the rise of heart disease deaths – including waiting lists to see heart specialists such as me, which are unacceptably high.

While my clinic sees patients rapidly, the heart care waiting list across England is 72 per cent greater than in February 2020.

This is an increase of 169,000 people – enough to fill Wembley Stadium nearly twice over. The longer people wait for treatment, the higher their risk of becoming disabled from heart failure or dying prematurely.

Nor is the ambulance service working as well as it should be: average ambulance response times in England for category 2 calls – which include suspected heart attacks and strokes – were 46 minutes in December, up from 39 minutes in November.

REMOTE GP consultations are a real help in lots of ways, but they may make it harder for people to keep on top of their blood pressure checks, which would have been routinely done at face-to-face appointments. High blood pressure is a major risk factor for heart disease, but it often has few or no symptoms until it causes a heart attack or a stroke.

other drivers include our increasingly sedentary lifestyles and poor diets, with lots of saturated fat, sugar and salt, which raise the risk of cardiovascular disease later in life.

more needs to be done in education and making it easier for people to make healthier choices within their budgets so they don’t develop heart disease in the first place.