This article is part of our special report Cardiovascular disease: Not only about lifestyle?.
The pandemic should be seen as a wake-up call for EU policymakers to take a more focused approach toward cardiovascular diseases (CVD), Europe’s number one killer, as patients have already paid a heavy price due to COVID-19, stakeholders warned.
According to the European Commission, more than six million new cases and over 1.8 million cardiovascular disease-related deaths are reported in the EU each year, costing the EU economy over €210 billion annually.
A report published by PwC consultancy and the EU pharma industry association (EFPIA) found that CVD patients were among the most vulnerable groups of patients during the pandemic.
“COVID-19 led to significant disruptions of CVD care, pre-existing CVD raised the risk for severe COVID-19 disease and last but not least, CVD-related long-term complications from COVID-19 are emerging,” the report said.
The projections of long-COVID are also alarming, as experts expect the long-term complications to be an additional public health burden.
“COVID-19 gave oxygen to the fire of cardiovascular disease […] It exposed the vulnerability of all those living with undetected underlying cardiovascular conditions,” according to Neil Johnson, founder of the Global Heart Hub patient group.
CVD: Not just a lifestyle disease
CVDs are often seen as being related to bad lifestyles, but for Birgit Beger, CEO of the European Heart Network, this must change.
“CVD is not just a lifestyle disease, and patients are suffering from it. For example, we cannot overlook those at risk due to genetic predisposition. What we need to address is to grant access to health care delivery,” she said.
Speaking at an event last Friday (13 May), Beger said the CVD situation in Europe was already bad before the pandemic and deteriorated further with COVID-19.
“More than 60 million people were living in the EU with CVD, then the pandemic came and was a double-edged sword, on the one hand, side slaying those with CVD, and other people surviving COVID coming out with the CVD outcome, so it could not get worse,” she said.
Screening is key in preventing CVDs
The speakers at the event also highlighted projections for more pandemics to come and stressed the need to take early action to prevent CVD through screening.
“Prevention is better than cure. So, if evidence-based and quality assured cardiovascular health checks are in place, you can catch people early, then you can intervene much more targeted and much more sufficiently than trying to remedy the damage,” Beger said, adding that screening capacity diverges significantly between Europe’s west and east.
To address the inequality issue, Ömer Saka from PwC Switzerland proposed an “inequalities registry” similar to the one existing for the EU Cancer Plan, which collects data on the disease’s prevalence and challenges citizens face when accessing treatments.
The PwC report also emphasised the need for enhanced screening of the population across the bloc and simplifying access to it, considering that many CVD cases remain undetected.
Notably, the report called on EU governments to “systematically and proactively detect and manage people’s risk of developing CVD and elevated risk of progressing to severe cardiac events”.
“Each country to spell out ambitious, yet feasible goals for CVD management policy through national plans, supported by clear and tangible KPIs aligned at European level”, the report reads.
Another critical element of the report is the creation of “region-wide registry capabilities” to monitor outcomes and collect data on interventions in a meaningful way.
“Better use of data and digital will help identify the right patients for these interventions and provide better data for research and development of innovative treatments”, the report notes.
For Beger, Europe has “brilliant” technology capabilities to digitise its health sector through public investment. Still, this innovation should not accelerate existing inequality but make it accessible so that everyone can participate in it.
Data collection: A complex equation
The European Commission hails the EU-wide data collection as an essential step to effectively address CVDs. However, officials warn it’s not an easy task considering the complexity of coordinating 27 member states.
“The real challenge is to motivate the member states to make changes in the system because that means that people who for decades think in a certain way need to do it in a different way,” said Stefan Schreck from the Commission’s Directorate-General for Health and Food Safety.
Schreck described a complex situation regarding data collection because of GDPR rules and the high cost of harmonising all data across the bloc.
“This is always a very challenging discussion with member states. For example, we can see that we need to have better data on communicable diseases as a direct consequence of COVID-19. And already that is not so easy as a discussion, let alone for non-communicable diseases,” he said.
In early May, the EU executive presented the much-awaited “European Health Data Space (EHDS)”, which aims to pave the way for a “health data revolution” among member states.
The proposal intends to address the limited use of digital health data in the EU because of different standards among member states and limited interoperability.
Schreck explained that the knowledge is there in Europe, but the problem is applying it in practice.
The EU official, therefore, proposed a bottom-up approach by incentivising member states to stop working in silos and coordinate, as the traditional way “of writing documents” dictating to EU capitals what they should do, did not work effectively in the past.
[Edited by Alice Taylor]