Prioritizing cardiovascular health as we age

In the year 2021, an estimated 20.5 million individuals passed away due to a heart-related ailment, significantly surpassing the number of deaths caused by COVID-19 or any other illnesses.^1,2
As the population continues to age, the number of individuals aged 60 and above is projected to increase to 2.1 billion by 2050.³

The healthcare industry is anticipating an increase in age-related illnesses, like type 2 diabetes and hypertension, which can lead to a higher likelihood of heart failure for individuals.

In order to maintain heart health as individuals get older, it is crucial to enhance awareness and recognition of symptoms related to heart failure.

Collectively called cardiometabolic diseases, they are a huge threat to our collective health and the strength of our global health ecosystems. The economic burden of heart failure is estimated to cost €282 billion per year in Europe.⁴ In recognizing the scale of the problem, the U.N.’s Decade of Healthy Ageing (2021-2030) is a global collaboration aimed at ‘adding life to our years’ and aligns with the final 10 years of the Sustainable Development Goals, which include reducing premature mortality from noncommunicable diseases.

Maintaining cardiovascular health as individuals get older.

The indications and manifestations of heart failure are frequently vague, or may not appear at all.⁵

This, along with individuals having jam-packed schedules and limited knowledge of warning signs, may result in their heart health being neglected. It is crucial to increase understanding of general heart symptoms and assist people in controlling established risk factors, like being overweight and using tobacco.

Aistė Štaraitė, chair of the Heart Failure Patient Council at the Global Heart Hub, emphasized the importance of increasing people’s knowledge and recognition of heart failure symptoms as they age. This requires collaboration with healthcare professionals, patient advocates, and patient organizations to promote awareness and encourage individuals to proactively undergo testing.

To tackle this issue, we must put in place a national strategy and action plans for cardiometabolic diseases, similar to Spain’s Cardiovascular Health (CVH) Strategy.^6,7

“We need clear guidelines for investing in prevention, early detection, diagnostics, and management strategies throughout the entire healthcare process. This involves transforming care pathways to incorporate integrated, multidisciplinary programs that eliminate barriers in care. Implementing a more cohesive approach for patients with multiple cardiometabolic conditions could enhance patient outcomes and have positive impacts on the healthcare system and economy.”

The importance of diagnostic tests for maintaining cardiovascular health

In addition to promoting education and integrating care, it is crucial to prioritize the availability of diagnostic testing to empower patients in managing their health. Identifying individuals who are at high risk for heart failure before symptoms arise and providing early diagnosis can help them receive the most effective and comprehensive treatment.

A blood test can identify the existence of natriuretic peptides (NP) in the blood, which serves as a biomarker for elevated heart failure levels.⁸

Although this test is relatively simple, it is included in European guidelines for use in primary care and for individuals with diabetes who are suspected of having heart failure. ^9,10

Approximately 80% of incidents of heart failure are not identified until the individual is admitted to an emergency room.¹¹

At this stage, permanent harm may have already taken place. Additionally, research conducted in the United Kingdom revealed that only a quarter of patients diagnosed with heart failure in primary care had undergone testing six months prior to their diagnosis.¹¹

There is an increasing disparity in the availability of diagnostic tools within our healthcare systems, as well as in our perception of the significance of diagnostic data.

Policymakers should prioritize increasing availability of heart failure diagnostic tests, such as NP, to individuals with comorbidities like type 2 diabetes. This can be achieved through initiatives like the ‘3 As’ strategy, which seeks to enhance awareness, accessibility, and adoption of NP testing in primary care. Additionally, investing in diagnostic capabilities by expanding and diversifying the healthcare workforce, particularly in primary care, can help alleviate the strain on emergency care and provide individuals with a better understanding of their heart health.

Enhancing equal availability of diagnostic services

The importance of using diagnostics in identifying and managing cardiometabolic disease is evident, as it brings numerous benefits for patients, society, and the economy. However, there is a need for investment in the creation of new diagnostics and addressing the obstacles to obtaining existing ones. In-vitro diagnostics, which involve testing blood or tissue samples, play a crucial role in nearly 70 percent of medical decisions but receive only 2 percent of global healthcare funding.¹²

Hans Martens, president of the European Association of Value-Based Health, stated that there is increasing disparity in the availability of diagnostic tools and in the recognition of their importance within our healthcare systems.

The push for increased accessibility has gained support from the global community. During the 76th World Health Assembly, government delegates from various countries passed a resolution to improve diagnostic capabilities. This is a significant step forward, as currently, less than half of the world’s population has limited or no access to crucial diagnostic tools, with this number rising to 81 percent in low-income nations.¹³

The resolution could play a vital role in increasing accessibility to diagnostic tools and ultimately reaching universal health coverage. It emphasizes the importance of creating national plans, training workers with necessary skills, improving laboratory systems and infrastructure, and implementing regulatory frameworks that speed up access.

A request to prioritize cardiovascular wellness

As the world’s population ages and the 2030 deadline for Sustainable Development Goals draws near, it is crucial to act now for a healthier future. This includes investing in global access to diagnostic testing, promoting education, and implementing plans and pathways for cardiometabolic care. By prioritizing prevention, diagnosis, prognosis, and monitoring of heart health, we can improve health outcomes and effectively manage resources as the population ages, leading to longer and healthier lives for individuals.

Learn from professionals about the importance of using diagnostic tools to monitor heart health as individuals get older.

References

1. According to a recent report from the World Heart Federation, there has been a 60% increase in deaths from cardiovascular disease worldwide in the past 30 years. This information is available at https://world-heart-federation.org/news/deaths-from-cardiovascular-disease-surged-60-globally-over-the-last-30-years-report/ and was accessed in August 2023.

2. The website “Our World in Data” provides information on the leading causes of death. This data can be found at https://ourworldindata.org/causes-of-death#:~:text=Cardiovascular%20disease%20is%20the%20top,cardiovascular%20diseases%20across%20the%20world. It was accessed in August 2023.

3. The World Health Organization has information on ageing and health on their website, which can be accessed at https://www.who.int/news-room/fact-sheets/detail/ageing-and-health#:~:text=By%202050%2C%20the%20world’s%20population,2050%20to%20reach%20426%20million. This information was last accessed in April 2023.

4. Luengo-Fernandez R, et al. Economic burden of cardiovascular diseases in the European Union: a population-based cost study, European Heart Journal, 2023;, ehad583, https://doi.org/10.1093/eurheartj/ehad583.

5. The American Heart Association provides information on how to manage symptoms of heart failure. This resource can be accessed at https://www.heart.org/en/health-topics/heart-failure/warning-signs-of-heart-failure/managing-heart-failure-symptoms and was last accessed in August 2023.

6. Cardiovascular Health Strategy, Spain’s National Health System Executive Summary. Available at: https://www.sanidad.gob.es/organizacion/sns/planCalidadSNS/pdf/ESCAV_Executive_Summary.pdf. Accessed: August 2023.

7. The Cardiovascular Health Strategy for Spain’s National Health System is accessible at https://www.sanidad.gob.es/organizacion/sns/planCalidadSNS/pdf/ESCAV_Summary_Presentation.pdf and was last accessed in August 2023.

8. The authors of this study, Kimmoun A and colleagues, aim to determine the safety, tolerability, and effectiveness of a method called Rapid Optimization in improving heart failure treatments. This method will be aided by two biomarkers, NT-proBNP and GDF-15. The study, called STRONG-HF, is designed as a randomized, multicentre trial with parallel groups. It was published in the European Journal of Heart Failure in November 2019.

9. Bayes-Genis and Rosano (2023) propose a strategy to utilize natriuretic peptide testing in primary care for the early diagnosis of heart failure. They present a roadmap for this approach in the European Journal of Heart Failure, highlighting its potential benefits.

10. Marx N, et al. ESC Scientific Document Group. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J. 2023 Aug 25:ehad192. doi: 10.1093/eurheartj/ehad192. Epub ahead of print. PMID: 37622663.

11. The British Heart Foundation published an article discussing the consequences of delayed diagnosis for heart failure, emphasizing the importance of early detection. The article can be found at https://www.bhf.org.uk/for-professionals/healthcare-professionals/blog/2019/rushed-to-hospital-when-heart-failure-isnt-diagnosed-early-enough and was accessed in August 2023.

12. Rohr UP, Binder C, Dieterle T, et al. The Value of In Vitro Diagnostic Testing in Medical Practice: A Status Report [published correction appears in PLoS One. 2016;11(4):e0154008]. PLoS One. 2016;11(3):e0149856. Published 2016 Mar 4. doi:10.1371/journal.pone.0149856
13. .

    Fleming and colleagues’ 2021 study, “The Lancet Commission on Diagnostics: Transforming Access to Diagnostics,” explores the potential for improving access to diagnostics through a thorough analysis of the current landscape. Published in The Lancet, the study covers a range of topics from 1997 to 2050.