Cardiovascular Diseases: A Growing Public Health Crisis
Cardiovascular diseases (CVDs) remain the leading cause of death in the European Union (EU), affecting over 13 million people annually and causing around 1.7 million deaths each year — roughly the population of Munich. This staggering figure underscores the urgent need to address CVDs as a critical public health priority. The gravity of the situation cannot be overstated, with CVDs not only causing high mortality rates but also impacting the quality of life for millions of European citizens.
One of the significant challenges in combating CVDs is ageism, which has led to the under-detection, under-diagnosis, and under-treatment of Structural Heart Diseases (SHDs). SHD is a term used to describe a collection of diseases that affect the structure of the heart, including heart valve diseases. As the prevalence of SHD rises with age, there is a concerning risk that symptoms will be misinterpreted as normal signs of aging. Early detection is crucial, as untreated SHD leads to a dramatic decline in physical functioning, emotional well-being, and overall health.
The Alarming Rise of SHD
In 2020, approximately 14 million people in Europe were living with SHD, and this number is expected to rise to 20 million by 2040. While treatments for SHD are highly effective, SHD continues to be significantly underdiagnosed across the continent. For example, without treatment, the mortality rate for patients with severe heart valve disease is 50% within two years of the onset of symptoms, climbing to 75% within three years. These statistics reflect the urgency of increasing awareness, improving diagnosis, and ensuring timely treatment for SHD patients.
At the same time, it is important to note the disparities in SHD detection and treatment that arise due to ageism, gender, socio-economic status, and geographical inequalities. Better data collection is essential to track these disparities and for health services to take action to address them.
Addressing Health Inequalities in SHD
Health inequalities are pervasive in Europe, and they significantly affect outcomes for people with CVDs, including SHD. Several factors contribute to these inequalities, such as socio-economic status, geographical location, and gender. Studies have shown that life expectancy varies considerably across the continent, with Eastern European countries often lagging behind Western European nations. For instance, life expectancy in Latvia is nearly nine years lower than in Spain. Furthermore, cardiovascular disease remains the most common cause of death for women across the EU, yet a 2019 heart survey found that general practitioners (GPs) were less likely to perform heart health checks on women compared to men (24.2% vs. 31.3%).
Additionally, lower socio-economic groups are disproportionately affected by SHD. In England, for example, individuals from deprived communities are four times more likely to die prematurely from CVD compared to those from more affluent areas. In Germany, wealthier patients, who often have private insurance, enjoy quicker access to healthcare services and are more likely to be aware of SHD, leading to earlier detection and better outcomes.
A Call to Action: Prioritizing Early Detection
The European healthcare systems must adopt a more proactive approach to detecting and treating SHD. This includes:
- Improved Screening and Awareness Campaigns: Governments should introduce annual health checks for adults aged 65 and older that include stethoscope checks and screenings for SHD risk factors. Early detection is essential for preventing SHD from becoming life-threatening and ensuring timely intervention.
- Tackling Inequalities in SHD Care: Addressing the disparities in SHD care requires a concerted effort to ensure that marginalised groups — including those from lower socio-economic backgrounds, rural communities, and ethnic minorities — receive equal access to screening, diagnosis, and treatment services.
- Innovative Healthcare Solutions: Digital health tools, such as digital stethoscopes, should be integrated into routine GP check-ups to facilitate earlier diagnosis of SHD. For example, the Chapel Lane Pharmacy pilot project in the UK demonstrates how pharmacies can play a critical role in early detection by using digital stethoscopes to detect heart murmurs in the community. These technologies have been instrumental in identifying patients at risk of heart valve disease, and their widespread use could have a profound impact on reducing SHD mortality.
- Raising Public Awareness: Public education campaigns are essential in ensuring that older people recognize SHD symptoms early and seek medical help. Increased awareness of the risks associated with SHD can empower older adults to advocate for themselves within healthcare settings and encourage GPs to prioritize SHD checks.
Conclusion: Prioritising Heart Health for a Healthier Future
As we look toward the future, it is essential to prioritise cardiovascular health, particularly among older populations. By tackling the inequalities in SHD detection and treatment and ensuring that early diagnosis becomes a routine part of healthcare, Europe can make significant strides in reducing CVD-related deaths. The time to act is now — and it begins with a commitment to improving early detection and treatment for all, regardless of age, gender, or socio-economic background.