Scots gaining weight is 'slowing progress' on heart attacks and strokes

Weight gain and increasing rates of diabetes are slowing efforts to reduce the number of heart attacks and strokes, according to research funded by the British Heart Foundation (BHF).

Dr Anoop Shah, BHF Clinical Research Fellow at the London School of Hygiene and Tropical Medicine.
Dr Anoop Shah, BHF Clinical Research Fellow at the London School of Hygiene and Tropical Medicine.

Decreases in three major risk factors contributed to a fall in the number of heart attacks and strokes between 1990 and 2014, researchers from the London School of Hygiene and Tropical Medicine found using Scottish data.

However, progress in reducing numbers further has been stalled by increasing body mass index (BMI) and diabetes prevalence over the same period, they found.

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The findings show a need for “urgency” in tackling obesity, said James Jopling, head of the BHF in Scotland.

Heart attacks fell from 1,069 per 100,000 people to 276 per 100,000 between 1990 and 2014, researchers found. Ischaemic strokes (a type of stroke caused by a blood clot) fell from 608 per 100,000 to 188 per 100,000 people.

Some 74 per cent of the fall in heart attacks and 68 per cent in strokes was due to changes in risk factor prevalence, driven by decreases in blood pressure, cholesterol levels and smoking rates.

Average BMI in Scotland has increased since 1990, and the rate of diabetes has doubled, from four to nine per cent of the population.

This has caused a 20 per cent increase in heart attacks and 15 per cent increase in ischaemic strokes attributable to these two risk factors, the researchers said.

Additional survey results show the number of people with diabetes and obesity in Scotland has increased over the last decades, with 66 per cent of adults in Scotland now having a weight defined as obese or overweight and around 300,000 people diagnosed with diabetes.

Analysis also shows the contribution of diabetes to heart and circulatory diseases has also increased, with the estimated proportion of cardiovascular deaths associated with diabetes at 28 per cent in 2019.

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Dr Anoop Shah, BHF clinical research fellow at the London School of Hygiene and Tropical Medicine, who led the research, said: “The amount that different risk factors contribute to heart attacks and strokes has shifted over the last 25 years. Weight gain and diabetes now play a more prominent role in the development of these conditions. Public health policy urgently needs to incorporate these, taking a more holistic view of the range of risk factors that can lead to heart and circulatory diseases.

“There’s a time lag between people contracting diabetes and developing heart and circulatory disease. We need to act now to address these important risk factors or we risk seeing the impact of these increases for decades to come.”

James Jopling, head of British Heart Foundation Scotland, said: “These findings show the need for urgency in tackling obesity in Scotland, which could help prevent thousands of deaths from heart disease and stroke, two of Scotland’s leading killers.

“BHF Scotland has been working with 10 of the leading health charities in Scotland to reinvigorate the public health debate regarding health harming products, such as tobacco, alcohol, and food and drinks high in fat, salt and sugar. The Scottish Government’s long anticipated Price Promotion Bill needs to be tabled urgently to help address some of the root causes of the increase in obesity and to make the healthy choice the easy choice in Scotland.”

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