New cardiovascular disease treatments urgently needed, experts say

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While heart problems remain the biggest cause of death among EU citizens, experts say current treatments are limited and more research needs to be done to benefit patients. 

Cardiovascular disease is the number one cause of death globally; more people die annually from that condition than from any other cause, according to statistics from the World Health Organization (WHO).

In addition to the health burden, cardiovascular problems also have a significant economic impact, estimated by the European Heart Network (EHN) at €196 billion in the EU for direct and indirect annual costs.

The condition spans from coronary heart conditions, to stroke, peripheral arterial or aortic diseases. They are the leading causes of disability in the Western world, accounting for 24% of all deaths globally.

Based on US data, heart problems claims more lives each year than cancer, chronic lower respiratory disease, and accidents combined.

Each year, 4 million people die in Europe from cardiovascular disease, says the EHN. There are large variations in death rates between countries due to differences in the levels of obesity, physical inactivity, and tobacco use.

The main lifestyle aspects which affect the risk are smoking, diet, physical activity and alcohol consumption. The effects of an unhealthy diet or physical inactivity for example, may present in individuals as hypertension, raised cholesterol, obesity, and diabetes, all of which indicate an increased risk of developing the condition.

The costs are not solely incurred by healthcare costs: around a quarter is the result of the cost of low productivity from those affected by cardiovascular disease; a further quarter is the estimated cost of informal care – the income that family and friends forgo looking after those with the condition.

New research on cholesterol

Last week, the Commission launched its first ever initiative on physical activity. However, health experts say the EU also has to focus on research and innovation. The burden of heart problems is now so significant that the problems also have to be fought with new medical therapies and can’t be met with those currently available.

Alberico Catapano, professor of pharmacology at the University of Milan's Faculty of Pharmacy, said at the European Society of Cardiology (ESC) Congress 2013 in Amsterdam on Saturday (31 August) that there were several reasons why more research was needed.

“One is that cardiovascular disease remains a major global problem. Many different numbers show a compelling need for new treatment of cardiovascular diseases,” the professor said.

Research has shown that there is a strong correlation between having too much of the “bad” cholesterol and the risk of heart disease and stroke. Common risk factors are usually treated with statins.

While statins have been consistently proven to reduce the level of the bad cholesterol by 20-55% and reduce the risk of cardiovascular events, a significant proportion of high-risk patients may not experience any reduction of the cholesterol level from the statin therapy.

Beyond statins, current therapeutic options are limited and provide only a small reduction to the bad cholesterol level. Physicians say there is a need for additional medications that can help patients achieve their cholesterol goal.

But they are optimistic. The enzyme PCSK9, pinpointed by genetic researchers, could become the next drug for the 5-10% of the population which do not tolerate statins at all.

“This is the first impressive therapy that we have found in the last 30 years, since the discovery of statins. It appears promising in efficacy and safety,” said Eli Roth, medical director of the Sterling Research Group, and director of Preventive Cardiology at the University of Cincinnati Medical Centre.

More research still has to be done on the matter, but researchers hope they can start providing patients with new treatments within a few years’ time.

Approximately 4 million people in Europe and 1.5 million people in the EU die of cardiovascular disease each year, according to the European Heart Network (EHN). The main forms of heart disease are coronary heart disease and stroke.

To reduce the amounts of death from heart diseases, European Union countries agreed to tackle the underlying health determinants behind cardiovascular health in its 2003-2008 health action programme.

A key element in fighting cardiovascular disease is to address the underlying health determinants, including tobacco use, obesity, diet and physical activity and high blood pressure.

  • 31 Aug.-4 Sept.: European Society of Cardiology (ESC) Congress 2013 in Amsterdam.
  • 17 Sept.: Conference on obesity "Eat well, drink well, move ... A small step for you, a big step for Europe" to be held in Brussels.
  • 29 Sept.: World Heart Day.

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