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A new heart health crisis is looming

Simon Gillespie

We’ve made incredible progress in transforming survival rates for heart attack and stroke; people’s experiences of living with heart and circulatory diseases today are very different.

When the NHS was established in 1948, half of all deaths in the UK were caused by heart and circulatory diseases. Today, it’s reduced to a quarter – a testament to the power of research. However, we’ve seen the opposite trend in the number of patients visiting GP surgeries and hospitals suffering from multiple, long-term diseases.

Vast improvements in treatments for heart and circulatory diseases mean people are living longer with a range of complex conditions, which current methods of care and treatment are struggling to deal with. This is, or should be, of grave concern.

How are heart and circulatory diseases connected with wider conditions?

Our latest figures reveal that nine out of ten people living with long-term heart and circulatory diseases suffer from at least one or more further conditions, including stroke, dementia and high blood pressure.

“People with more than one illness are at greater risk of succumbing to physical disability and premature death.”

These diseases are usually connected. When your heart isn’t beating properly and your blood flow is disrupted it can have a devastating affect all over your body.

This has huge consequences. People with more than one illness are at greater risk of succumbing to physical disability, premature death and will also have a poorer quality of life. This, in turn, places huge strain on family and social support teams. In many cases, supporting loved ones can take over the lives of families and carers. Most people who suffer from multiple conditions are not aware of how one condition can lead to another.

Personalised treatment is a challenge for the NHS

But more people living with multiple conditions is also an alarming challenge for the NHS, which is already under unprecedented strain. Like many health systems around the world, the NHS is designed to treat individual illnesses rather than individual patients. Not enough research has been undertaken into how to treat different illnesses together or how we can innovate to provide personalised approaches to unique combinations of conditions.

“One in three stroke survivors will develop dementia within five years.”

Nowhere is this truer than in the treatment of heart and circulatory diseases. A person with type 2 diabetes is more than twice as likely to have a heart attack compared with the general population. A heart attack survivor is twice as likely to have a stroke, and one in three stroke survivors will develop dementia within five years.

Yet these conditions are often treated separately. This means different medical appointments, different doctors and different medicines. We are not treating the individual. The result is more people being hospitalised, longer hospital stays, and ultimately worse outcomes for patients.

We need to radically change our approach

To effect such profound change we urgently need more research. Research that will help us identify conditions that tend to group together, and why. We also need to work out why some people appear more likely to suffer multiple conditions than others. Once we have identified those at risk, we need innovative ways of treating conditions together in ways that are personal to the individual.

“A heart attack survivor is twice as likely to have a stroke.”

But the NHS needs to play its part too. It needs a bold ambition to give personalised care to every patient and be committed to translating research into innovative changes in how healthcare is delivered.

Patients with diabetes should have easy and immediate access to heart disease services. Mental health services should be more closely linked to heart attack clinics and rehabilitation programmes to better support people’s physical and psychological health and wellbeing.

We don’t have the answers yet, but research is underway. Just like they did when the NHS was born through a bold idea, it’s time for scientists and clinicians to come together to overcome the biggest challenge we face in improving NHS care in the coming decades.