AS A LABOUR Member of Parliament with a strong interest in heart health issues, I have been very encouraged about progress made in the fight against coronary heart disease – rightly highlighted as a major health priority from our earliest days in government.
The Department of Health’s recent update reported particularly encouraging progress. Deaths from cardiovascular disease fell by more than 23 per cent between 1995 and 2002, and today eight in 10 heart attack patients receive life-saving thrombolysis treatment within 30 minutes of hospital arrival – compared to less than four in 10 in 2000.
However, as the Chair of the All-Party Parliamentary Group (APPG) on Heart Disease I am only too aware that coronary heart disease remains the UK’s single biggest killer.
The statistics remain sobering:
• Heart and circulatory disease kills 240,000 people every year in the UK
• Around 125,000 women die from heart and circulatory disease each year, com-pared to 76,000 from cancer
• Two million people are living with angina, and another 655,000 have heart failure in the UK
• Thousands more are recovering from heart attacks or heart surgery.
So after the publication of a National Service Framework for Coronary Heart Disease, and increased investment in coronary heart disease, what more can the government do to bring down the numbers of people who continue to suffer?
The government’s current attempt to address the public health crisis that could reverse progress made in combating coronary heart disease in the UK is to be welcomed. Obesity, inactivity and high levels of smoking in the UK are major risk factors for coronary heart disease that must not be ignored.
However, another cost-effective way of achieving a significant further reduction in coronary heart disease could be secured through patient education and empowerment, with patients being made more aware of heart health risks and of possible solutions to help them reduce the risk of developing coronary heart disease in later life. For this reason, I was encouraged by the government’s recent announcement that cholesterol-lowering drugs, statins, will become available through pharmacies without prescription.
We have known for some time about the clinical effectiveness of statins in reducing blood cholesterol. Research funded by the British Heart Foundation has shown that a third of heart attacks and strokes could be prevented in people at high risk of vascular disease by taking 40mg per day simvastatin to lower blood cholesterol levels. 1 In people at risk, but not as high a risk of heart attack and stroke, taking 10mg of simvastatin each night could reduce their risk by about 27 per cent. 2 It is this group of people that
the government hopes to target with the offer of low dose statins.
It has also been demonstrated that even patients at risk of coronary heart disease who do not have high cholesterol levels should benefit from taking statins – and the safety of statins has been demonstrated in its widespread use over 14 years.
However, in order to calculate a person’s risk of coronary heart disease, it is necessary to know their blood pressure, blood cholesterol level, gender, age, ethnicity, whether or not they have diabetes, or if they smoke. We must ensure pharmacists encourage-age patients to have reliable cholesterol checks so that these drugs reach the right people at the right dose. Many patients will need higher doses if they are at high risk of coronary heart disease and should not be under-treated.
All health professionals also need to work together and share information and have a system in place for pharmacists to let GPs know which of their patients have been prescribed low dose simvastatin.
I would be concerned, however, if statins came to be seen as wonder drugs and were used as an excuse by people wishing to avoid making the life-style changes that could improve their health outcomes. Our best chance of securing further progress in reducing the incidence of coronary heart disease remains the prospect of more people stopping smoking, controlling their weight, eating a balanced diet and taking more exercise.
For this reason, the All-Party Parliamentary Group on Heart Disease is calling on the Department of Health to ensure that evidence-based, tangible solutions are included in its forthcoming white paper on public health. Much has been achieved in our fight against coronary heart disease, but we must continue to prioritise the push towards tackling the UK’s single biggest killer. The fight is far from over.
