Heart disease Scotland: Urgent action needed to 'revive UK's heart care'

There are growing inequalities in UK healthcare when it comes to heart disease, new research funded by the British Heart Foundation shows.

Urgent action is needed “to revive heart care”, a charity has warned, after new research showed increasingly stark inequalities in diagnosis and treatment of heart conditions across the UK.

Research funded by the British Heart Foundation (BHF) and published in The Lancet shows women are less likely than men to undergo coronary angiograms, a crucial procedure to look inside their heart’s arteries, after a heart attack. Women are also less likely to be prescribed preventative treatments that can help ward off future heart attacks.

The research highlights an estimated 500 potentially avoidable deaths in the UK each year among patients waiting for treatment for aortic stenosis, a narrowing of the heart’s aortic valve that restricts blood flow around the body.

An estimated 500 potentially avoidable deaths take place in the UK each year among patients waiting for treatment for aortic stenosis

The BHF says the research paints a concerning picture of unequal care.

Professor Chris P Gale, professor of cardiovascular medicine at the University of Leeds and honorary consultant cardiologist at Leeds Teaching Hospitals NHS Trust, led the research.

“We need urgent action to revive heart care,” Prof Gale said. “The NHS is full of fantastic people who make truly monumental efforts every day to do the very best for their patients. Despite this, the NHS is creaking at the seams, and we see this played out in cardiovascular care and outcomes.

“Past efforts to transform heart care and drive down waiting lists were hugely successful, and we must build on the lessons from these to move forward.”

Researchers brought together evidence from studies published over the past 20 years that explored how a person’s age, sex, ethnicity and postcode are linked to the heart care they receive and their outcomes.

The team focused on heart attacks, heart failure, atrial fibrillation and aortic stenosis as these conditions lead to significant pressure on the NHS.

The review shows older people and women are less likely to receive the treatment recommended in clinical guidelines if they have a heart attack or are diagnosed with heart failure.

While the evidence for age, sex and geography was clear, the researchers say that it is harder to draw conclusions about the experiences of patients of different ethnicities due to a lack of evidence.

However, from the studies available researchers say they believe that disparities do exist. For example, there was evidence that black patients with atrial fibrillation (a common type of abnormal heart rhythm) are less likely to receive blood thinning treatment to prevent stroke than white patients.

Dr Sonya Babu-Narayan, associate medical director at the British Heart Foundation and consultant cardiologist, said: “These findings should sound the alarm bell for the state of heart care in the UK.

“This concerning review is further evidence that people’s experience of heart care was far from equal even before the Covid-19 pandemic began. The pandemic underlined and amplified existing health inequalities, and we fear these are worse than ever now that we are firmly in the grip of a heart care crisis.

“To stop this crisis in its tracks and address the unjust inequalities in heart care, we need bold action from government.”