Winning the war on heart disease deaths

Published on Wednesday 31 October 2007 00:57

IT SEEMED like an almost impossible target - cutting Scotland's massive burden of deaths from heart disease by almost two-thirds in just 15 years.

But advances in treatment, better drugs and a growing awareness of the importance of a healthy lifestyle appear to be paying off.

New figures released yesterday revealed that the death rate from heart disease among under-75s dropped by 8.4 per cent in just one year. Deaths from stroke also fell by almost 3 per cent between 2005 and 2006.

The statistics mean that Scotland is on track to meet two key targets in the battle to lose its "sick man of Europe" title.

Health campaigners and politicians yesterday welcomed the figures. However, charities warned that more needs to be done to tackle health inequalities between the rich and poor, who still suffer the highest rates of heart disease.

In 1999, a health white paper, Towards a Healthier Scotland, announced a target of cutting heart-disease deaths by 50 per cent among under-75s between 1995 and 2010.

Three years ago, ministers updated the target, aiming for a 60 per cent fall in deaths by 2010 - from 124.4 deaths per 100,000 people to just 49.8.

The latest Scottish Government figures show that the death rate dropped to 61.8 in 2006.

Statisticians last night said the ambitious 60 per cent target would be met if the current downward trend continued.

However, rising rates of obesity could cause problems as people grow older and suffer more ill-health.

The total number of deaths from heart disease among under-75s in 1995 was 6,908. By last year, this had decreased to 3,589, with hopes it will now drop even further.

New fast-track treatments for people who suffer heart attacks, cholesterol-lowering statin drugs and the introduction of the ban on smoking in public places have all been cited as contributory factors in falling heart-disease rates.

The figures also showed that cases of heart disease are down 8.4 per cent year-on-year, from 335.7 cases per 100,000 people in 2005, to 307.5 per 100,000 in 2006.

Emergency admission to hospital for heart attacks also dropped 8 per cent from March 2006 to March 2007 - the largest fall since 2000.

Figures for strokes showed that deaths among under-75s were down 2.9 per cent between 2005 and 2006 - on target to meet a 50 per cent reduction between 1995 and 2010.

Last night, campaigners were upbeat about progress being made to improve Scotland's health.

A spokeswoman for charity Chest, Heart & Stroke Scotland said: "It is excellent news that fewer Scots are being diagnosed with and dying from heart disease and strokes.

"Much of the fall in admissions to hospital can be attributed to community-based preventative medicine and the ban on smoking in public places which came into effect last year.

"The drop in mortality rates is primarily due to advances in specialist treatment for heart disease and stroke and increased access to specialist stroke units."

The spokeswoman added that many of the advances in treatment were the result of "dedicated research teams".

The number of prescriptions for drugs to tackle heart disease and strokes have almost doubled in the last decade - from 11.6 million in 1997 to 22.9 million in 2006.

But despite that rise, costs are beginning to fall as doctors start to use cheaper generic versions of drugs, including statins which significantly cut the risk of heart attacks.

Heart disease remains Scotland's second-biggest killer, accounting for around 17 per cent of deaths, followed by stroke with 10 per cent.

The figures also revealed wide variations in heart deaths between the most and least deprived members of the population. Last year, the death rates were more than four times higher among the most deprived groups. compared to the most well-off.

Other statistics have shown that Scotland lags behind the rest of the UK when it comes to tackling heart disease.

The British Heart Foundation (BHF) said death rates from heart disease were almost 70 per cent higher among men in Scotland compared to those in the south-east of England, and double for Scottish women.

Ben McKendrick, policy and public affairs manager for BHF Scotland, said: "It's very worrying that so little impact has been made in tackling inequalities in heart disease.

"People in the most deprived Scottish communities are still around five times more likely to die early from heart disease than people in our most affluent communities.

"It is shocking that inequalities of this scale exist in as small a nation as Scotland.

"BHF Scotland believes every person is entitled to benefit from health improvements, not just those in wealthy communities, and we urge the Scottish Government and NHS Boards to dedicate their efforts to tackle these inequalities once and for all."

Nicola Sturgeon, the Scottish health secretary, said it was "very encouraging" that fewer people were dying prematurely from coronary heart disease and stroke.

However, she pointed out that death rates were still higher in Scotland than in other western European countries.

She said: "The link between coronary heart disease mortality and deprivation needs attention. We must make sure all parts of Scottish society get the benefits of improvements to heart and stroke services."

Ms Sturgeon added: "The ban on smoking in public places will also contribute to the achievement of the target, and we're aware of the recent research which attributes to the smoking ban a 17 per cent reduction in the number of people admitted to hospital as an emergency following a heart attack."

Ross Finnie, health spokesman for the Scottish Liberal Democrats, urged the Scottish Government to focus on improving lifestyles in its bid to further reduce heart disease death rates.

He said: "These figures are a welcome sign that public-health initiatives, such as the ban on smoking in public places, are now having an impact on the health of the nation.

"Sadly, the rising incidence of obesity could reverse this trend. The Scottish Government must hammer home the message that a healthier lifestyle drastically reduces the chance of coronary heart disease."

Margaret Curran, Labour's shadow health secretary, said: "The reduction in the number of Scots dying from heart disease or stroke is good news for Scotland. I have no doubt this reduction and long-term trend is a direct result of Labour's commitment to tackling Scotland's big killers.

"However, I would urge the SNP not to become complacent. There remains more work to be done and the SNP must continue to drive down these figures."

THEY HELPED SAVE THOUSANDS OF LIVES

THE PROFESSOR

PROFESSOR Anna Dominiczak graduated from Poland's Medical School of Gdansk in 1978.

She has since made her home in Scotland, where she heads the British Heart Foundation's Glasgow Cardiovascular Research Centre. She has led work looking at the influence of genetic factors in heart disease.

Earlier this year she helped launch the UK Biobank study which is hoping to recruit 500,000 people to search for clues to heart disease and other conditions. The study will look at the relationship between genes, lifestyles and health, trying to find out why some people go on to develop diseases while others do not.

THE POLITICIAN

STEWART Maxwell is widely considered the architect of the bill which eventually led to the ban on smoking in public places.

In July 2003, he lodged a motion in the Scottish Parliament on the issue.

Mr Maxwell, the MSP for the West of Scotland, went on to introduce the bill to ban tobacco smoking in enclosed public places in February 2004.

There was initial opposition, but the then Scottish Executive eventually supported the SNP MSP's idea and the ban was introduced in March 2006.

Figures have suggested that admissions to hospital for heart attack have fallen by up to 20 per cent since the ban.

THE CHIEF DOCTOR

AS CHIEF Medical Officer, Dr Harry Burns has the unenviable task of improving Scotland's health.

In the battle against heart disease, he has been outspoken in highlighting the progress being made and the challenges Scotland still faces in tackling the problem.

His annual reports have highlighted the problems in bringing down heart disease deaths, while the population gets increasingly older. He has also helped to promote the importance of eating a balanced diet and taking exercise to combat rising levels of obesity and related ill-health.

Dr Burns has championed the importance of early treatment for heart disease.

THE PUBLIC HEALTH EXPERT

AS A professor of public health, Phil Hanlon has been at the forefront of efforts to encourage action to target obesity and poor diet.

After carrying out research in West Africa, he returned to Scotland and was later appointed director of health promotion at Greater Glasgow Health Board - the area of Scotland with the worst rates of ill health.

In 1994 Mr Hanlon moved to become a senior lecturer in public health at Glasgow University and was made professor in 1999. He has spoken of the importance of GPs giving advice to patients on how to reduce their risks of heart disease by telling them of the dangers of being overweight and of smoking.

THE CHARITY BOSS

DAVID Clark has been chief executive of Chest, Heart & Stroke Scotland since 1994.

The charity is a major funder of research into both heart disease and stroke north of the Border.

Mr Clark is a member of National Advisory Committee on coronary heart disease and stroke, overseeing implementation of the Scottish Government's strategy to tackle these issues. He is also a member of the group which puts together guidelines for the NHS in Scotland on the best way to treat heart disease.

The charity provides advice and information to patients and funds stroke-support nurses and a helpline for the public.

THE NURSING SISTER

SISTER Anne Taylor, who is based at Gartnavel Royal Hospital in Glasgow, has helped establish cardiac rehabilitation services in five hospitals across the city.

These specialise in helping to combat the high incidence of high blood pressure among patients of Asian origin, and have encouraged many people to seek help for the first time.

She has also set up three one-stop health clinics, providing services such as blood-pressure management for people facing cultural or language barriers to accessing health services.

The nurse, who grew up in India, said: "I feel so lucky I am able to help people."