The decline in death rates from heart disease in rich countries could be threatened by rising rates of obesity and diabetes, according to a study by European heart experts.
The research also found that the UK was lagging behind many lower income countries in some aspects of heart disease prevention - with high levels of obesity and inactivity.
The European Society of Cardiology (ESC) study involved academics from across the UK and Europe - including the University of Leeds - and analysed cardiovascular disease statistics for 56 member countries.
They included European nations as well as Russia, North Africa and parts of the Middle East, and the study represents a detailed analysis of heart disease and treatment services.
“Whilst the UK has seen a decline in deaths due to cardiovascular disease, one should not lose sight of the fact that key risk factors for cardiovascular disease are on the upturn.”
Published in the European Heart Journal, the analysis shows that huge inequalities persist with heart disease. It accounts for over 50 per cent of all deaths in many middle income countries, compared with less than 30 per cent in the high income countries of Western Europe.
The study says the decline in cardiac disease mortality in Western Europe has come from a reduction in heart attacks and strokes. The researchers say they took their data from credible sources including the World Health Organisation and World Bank but point out that some of the statistics were incomplete - although for most indicators the data return exceeded 80 per cent.
'Tragedy waiting to happen'
The reduction in cardiac death rates in Western Europe is now being threatened by the rise in obesity and type 2 diabetes, which are risk factors in heart disease. The researchers write in the paper: “The erosion of these health gains… is a tragedy waiting to happen.”
Chris Gale, Professor of Cardiovascular Medicine at the University of Leeds and a co-author in the study, said: “Whilst the UK has seen a decline in deaths due to cardiovascular disease, one should not lose sight of the fact that key risk factors for cardiovascular disease are on the upturn.
“In particular, in the UK we have seen an increase in the incidence of diabetes and childhood obesity.
“Tackling the epidemic of obesity and type 2 diabetes must be a NHS and public health priority to ensure that the UK continues to reduce the health and wealth burden of cardiovascular disease, and that a legacy of stroke, ischaemic heart disease and myocardial infarction (heart attack) is prevented.”
UK faces obesity challenge
The detailed statistical picture compiled by the researchers also reveals that while the UK performs well in some aspects of heart disease prevention, it is doing comparatively badly in terms of others. For example, the UK has:
- The highest prevalence of adult obesity in men (26.9 per cent of the population, compared to an average of 21.4 per cent among 47 countries), and the second highest prevalence of obesity in women (29.2 per cent, compared to an average of 22.9 per cent).
- The joint fourth highest body mass index (BMI) for men (27.5 kg/m2 compared to an average of 26.8 kg/m2 among 47 countries) and seventh highest BMI for women (27.1 kg/m2 compared to an average of 25.8 kg/m2).
- The third highest prevalence of insufficiently active adults at 40 per cent of the population, compared to an average of 26.5 per cent out of 36 countries.
On a more positive note, the UK has the lowest prevalence of raised blood pressure at 15.2 per cent of the adult population, compared to an average of 24.2 per cent among 47 countries, and the rate of smoking was among the lowest in Europe. This contributes to the UK’s position in the lower half of the cardiovascular mortality rankings for European Society of Cardiology member countries.
Failure of health policy
Adam Timmis, Professor of Clinical Cardiology at the Barts Heart Centre in London and lead author in the study, said: “Variation in the prevalence of major risk factors for cardiovascular disease represents a failure of effective health policy and public education that condemns large populations to premature death from ischemic heart disease and stroke.”
The data also shows that some lower income countries such as Bulgaria and Turkey compare favourably with richer nations when it comes to rates of catheterisation and stenting, procedures that are performed to tackle heart disease.
Professor Timmis added: “The (data) makes clear that economic resources are not the only driver for delivery of equitable cardiovascular healthcare, some middle income ESC member countries report rates for interventional procedures that match or exceed rates in wealthier high income member countries.”
The study involved an international collaboration of researchers from the Universities of Leeds, Queen Mary London, Oxford and East Anglia with academic colleagues in wider Europe.
The study used data from the World Health Organisation, World Bank, the European Society of Cardiology and the Institute of Health Metrics and Evaluation. Because of missing data and the differences in the way some countries report disease statistics, the authors say there needs to a 'cautious interpretation' of some of the cardiovascular disease statistics in the study.
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