This article is part of our special report Cardiovascular disease: Not only about lifestyle?.
EU policymakers should develop a more structured approach to improving cardiovascular health if the bloc wants to see tangible results in future healthcare, Dr Charmaine Griffiths, interim president of the European Heart Network (EHN) told EURACTIV in an interview.
Griffiths, also Chief Executive of the British Heart Foundation (BHF), explained that despite past progress in reductions in CVD mortality, CVD remains the leading cause of death in Europe and around the world.
“In the EU only, more than 60 million people are living with cardiovascular disease right now. Progress in reducing CVD mortality had started to slow even before the pandemic and, in some Western European countries (e.g. France, Germany and the United Kingdom), had even started to increase,” she said.
Several reports have confirmed that the pandemic has deteriorated an already alarming situation regarding CVDs.
While EU health policies and programmes address certain aspects and risk factors of CVD through prevention and health promotion policies, Dr Griffiths said, “our approach has lacked a coherent, structured and financed European Cardiovascular Health Plan”.
According to the expert, such a plan should aim to reduce premature and preventable deaths in Europe by one third by 2030, improve access for all to high-quality cardiovascular risk assessments, set multi-disciplinary care pathways and pave the way for a greater quality of life.
“To achieve this, focus will need to be on primary prevention at population level, improvements in secondary prevention through timely detection, equal access to high quality patient-centred healthcare and an increased uptake of rehabilitation,” she said.
The expert explained that the plan will be adjusted to the different realities in the EU member states, and an important aspect of implementation will be the creation of national CVH plans tailored to national realities and needs.
“A European Cardiovascular Health Plan with bold actions across the whole disease pathway will have a trickle-down effect and thus improve the resilience of health systems at national level as appropriate,” she said.
“Ultimately, keeping people in good health and optimise their quality of health will inevitably save and improve lives, strengthening resilience at population level and relieving the burden on healthcare systems and economies alike,” she added.
Focus on screening
Griffiths also emphasised the need for enhanced screening to detect and intervene early across the bloc, considering that there are currently wide discrepancies between Europe’s west and east.
“A life course approach must be adopted for screening programmes to detect those at high-risk in time; be it due to metabolic and inherited risk-factors, at birth, throughout childhood and specific junctures in adulthood and later life,” she said.
The expert said ideally, such a broader CV screening programme could be developed under a Joint Action like a “European Cardiovascular Health Check”, as has been recently proposed by the European Alliance for Cardiovascular Health, in which EHN is a member.
This would include strong health literacy and behavioural components, including, where needed, genetic counselling and a shift towards ‘personalised prevention’. Such an ambitious action will apply to emerging diagnostics and data-driven health technology.
These innovative technologies hold the promise to move care to a more holistic “whole patient” view by improving the accuracy of diagnosis, appropriate interventions, and evidence-based post-procedural care.
Gather data, save lives
The expert also referred to data gathering in CVDs, both on a national and EU level to achieve evidence-based decision-making throughout the cardiovascular disease pathway and reduce mortality and morbidity in patients.
“Digital health, big data and artificial intelligence hold great potential to detect cardiovascular diseases”, she said.
“The interoperability and implementation of electronic health records, as well as the convergence with real-life data and CVD registries, are crucial to realise a large-scale roll-out of digital health technologies,” she added.
Griffiths cited the SWEDEHEART Registry, which was launched in 2009 by merging four already existing quality registers to form Sweden’s largest quality register.
Its primary purpose is to support evidence-based therapy development in acute and chronic coronary heart disease and heart valve interventions by providing continuous data on care needs, examinations, treatments, and treatment outcomes.
“It also aims to capture changes in the quality of care over time within and across hospitals, contribute to risk assessment tools and decision-making and to support continuous improvement work at all participating units,” she said.
Cross-country longitudinal data sets, like SWEDEHEART, the expert said, can track progress over time to “identify where systems of care need to be adjusted at the hospital and regional level and offer academic opportunities for scientists to conduct clinical trials to identify effective prevention and treatment strategies in the short and long-term”.
[Edited by Alice Taylor]