Cardiovascular disease: ‘Better prevention would bring big healthcare savings’

Smoking and drinking alcohol are two avoidable risk factors for cardiovascular diseases. [Jules Pecnard/Flickr]

Cardiovascular diseases are still the world’s leading cause of death. Much more should be done to prevent the major risk factors, Philippe Thébault told EURACTIV France

Philippe Thébault is the President of the Alliance for the Heart (Alliance du Cœur), an umbrella organisation of French associations and federations linked to cardiovascular diseases.

Is public policy in France ambitious enough to deal with the cardiovascular risk factors like obesity, smoking and alcohol?

It is clear that we have no coherent policy for the ‘prevention’ of cardiovascular risk factors. Some other European countries have invested a lot more in both prevention and communication.

It would be easy to demonstrate that preventative action can bring big savings on patient care, emergencies and hospitalisations, thanks to small investments and concerted efforts by the public powers, patients’ associations, health professionals and the press!

Screening people with certain warning signs (hypercholesterolemia, diabetes, etc.) would bring them immediate access to treatment, prevent heart attacks and strokes and significantly reduce health spending.

What is stopping the politicians from taking action?

For some risk factors, like smoking or drinking alcohol, the companies concerned have lobbyists that are ready to do whatever it takes to protect their commercial activity, by influencing politicians in various ways.

Are there any other countries that have achieved tangible results in the reduction of these factors?

Certain Nordic countries have more systematic prevention practices, and they allocate more funding to informing people of the risks, which helps provide better care.

The link between cardiovascular diseases and air pollution is already well established, and taking action on the climate will also cut the number of premature deaths. Does the Alliance for the Heart expect anything from the COP21?

We have no great expectations, other than hoping for the launch of a plan that will be seen through to its end. Lots of ideas are raised in these big meetings, but very few amount to anything.

Without being pessimistic, we hope that the ideas to come out of the COP21 (however many there may be) will be taken into account at a national level, because the debate is often focussed on the global issues. That is a good thing, but enacting certain decisions on such a grand scale is a bit unrealistic.

Other diseases, like familial hypercholesterolemia, are not linked to external risk factors, but are genetic. In these cases, what action would you recommend?

As with any genetic disease, the best way to prevent it is of course to limit the risk factors, but above all to provide screening once the illness has been recognised within a family. Progress could be made by increasing the testing of men, who have fewer blood tests than women for various reasons.

Sufficient care can help control the illness and slow its progression.

Some people feel that health professionals are not well enough informed about rare diseases like familial hypercholesterolemia. What do you think?

Regrettably, FH, cardiac channelopathies, cardiomyopathy and other uncommon illnesses are often completely unknown to health professionals. 

Important work has to be carried out, particularly with the referral centres for rare diseases and today with all the health sectors, to spread the existing recommendations and best practices around the whole of the medical community.

We have to establish continuous training for general practitioners, who have the most contact with these patients. 

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