Women and people in most deprived groups are most likely to go undiagnosed.

Structural heart disease (SHD) affects the heart’s walls, muscles, and blood vessels. While most types of the disease can be successfully treated, many people are diagnosed too late or don’t receive adequate treatment leading to a high mortality rate and reduced quality of life, particularly in older adults.

A new report launched by the International Longevity Centre (ILC), the leading authority on the impact of longevity on society, finds that age, socio-economic status, gender, ethnicity, and geographical location significantly reduce the likelihood of being diagnosed and receiving treatment.

• A 2019 study across 11 European countries found women are less likely to regularly receive a heart check with a stethoscope by their GP than men, (24.2% women receive heart checks vs 31.3% men).
• In the UK, valvular heart disease, one of the most common forms of structural heart disease, is twice as likely to go undiagnosed in the most deprived socioeconomic groups than in the most affluent group.
• Across 57 countries (including in Europe, Central Asia and North Africa) mitral valve disease, one form of structural heart disease, is nearly five times as high in middle-income countries as in high-income countries.

Without improving detection and treatment, it is estimated the number of older adults with SHD will increase from 14 million to 20 million by 2040 in Europe (a 42% increase).

“One of the basic foundations of a good healthcare system is that individuals should have equal access to care.” Professor Huon Gray, Cardiologist, former National Clinical Director for Heart Disease, NHS England, UK

“Women’s symptoms can be much more subtle, and not always taken seriously.”
Dr Angela Lowenstern, Interventional Cardiologist, Vanderbilt University, USA

The Holding us back report, supported by Edwards Lifesciences, argues that more needs to be done to tackle these inequalities and provide people with the timely care they need. Delayed diagnosis or lack of treatment doesn’t only harm individuals’ health but also the economy. It’s estimated that European economies lose an estimated 210 billion EUR per year due to cardiovascular disease.

The report makes a series of recommendations for the WHO, EU, national governments, health systems, and public health bodies, including:

• The WHO should encourage all countries to update or develop their cardiovascular strategies to specifically include structural heart disease to raise awareness of the condition and how inequalities are driving disparities in detection and diagnosis.
• The EU should develop a Cardiovascular Health Plan, emulating the EU Cancer Plan, including an EU-wide target for early detection of structural heart disease.
• All countries should pilot screening programmes for Structural Heart Disease, which should include an objective to reduce inequalities through diagnosis at an earlier stage.

Arunima Himawan, Senior Health Research Lead, ILC and EU SHD Coalition Steering Committee member said:
 
“We have the tools to treat structural heart disease. But if we’re not detecting the disease early on, they’re useless. Too many older adults – especially from underserved communities – are needlessly dying and suffering from the condition. As our growing older adult population becomes increasingly diverse, policymakers will have to think more strategically about how to ensure everyone, not only the privileged few, benefits from living not just longer but healthier lives.”

“We have an opportunity to significantly reduce – and even eliminate – the structural heart disease burden but addressing inequalities must be at the heart of policy solutions. The conditions in which people are born, grow, work, live, and age shouldn’t impact their ability to receive care.”

Brando Benifei, MEP, argued:
 
“The EU has a responsibility to safeguard its ageing population including those that come from marginalised communities. The Structural Heart Disease burden is growing and will continue to grow without concerted action. To achieve this, we need strong leadership and commitment at the EU level and put forth an EU Cardiovascular health plan which recognises and sets a target to tackle the SHD burden.”

Ends

Contact

Contact press@ilcuk.org.uk or +44 (0) 773612496 for press queries. Spokespeople are available for interview.

Notes

The full report Holding us back? Tackling inequalities in the detection and treatment of structural heart disease in Europe is available at Holding us back? Tackling inequalities in the detection and treatment of structural heart disease in Europe – ILCUK

The ILC conducted desk research, interviewed 13 key stakeholders from across the SHD community, and held a workshop at the 17th World Congress on Public Health in Rome, attended by 10 public health experts.