See more information on the EU Heart Health Charter

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CVD Facts and Figures/ Irish Heart Foundation, July 2007

Why the

European Heart Health Charter?

Facts and Figures

Cardiovascular disease (CVD) comprises diseases of the heart, mainly Coronary Heart Disease (CHD), stroke and other atherosclerotic vascular diseases.  The

burden of CVD

is that it causes 36% of all deaths in Ireland, accounting for 10,000 deaths. In Europe and the EU, CVD causes more than half of deaths.  Overall CVD is estimated to

cost

the European Union economy €169 billion a year of which €866 million is the cost to the Irish economy. These costs include healthcare costs, loss of productivity and informal care.  Each year 7,000 people in Ireland and 450,000 people across Europe die from CVD due to

smoking

.  A

diet

that is high in fat, salt and sugar and low in complex carbohydrates, fruit and vegetables increases the risk of CVD. For instance, if people across the EU actually  consumed the minimum recommended level of fruit and vegetables, i.e. 400 g/day (5 portions), this could prevent 7% of CHD and 4% of stroke, or save over 50,000 lives per year. If they consumed 600 g/day we could reduce the risk of CHD by almost 18% and stroke by over 10%, or save over 135,000 lives per year 1 .

Obesity

levels are rising. In Ireland 1 in 5 adults are overweight or obese.

2 Around a third of CHD and a fifth of stroke in the developed world is due to high levels of BMI - and almost 60% of hypertensive disease is due to a high BMI.    In Ireland 200,000 are diagnosed with

diabetes

, with an additional 200,000 undiagnosed.

3 Over 23 million adults in the EU have diabetes, and the level is rising. Over half of the Irish population over the age of 50 years have raised

blood pressure

Influences

 A parental history of CHD is considered to reflect genetic, biochemical and behavioural components that may predispose an individual to be at higher risk of 4

.

Levels of

physical inactivity

are high. About 60% of the adult population do not take adequate levels of physical activity.

5 It is estimated that over 20% of CHD and 10% of stroke in the developed world is due to physical inactivity. cardiovascular disease.  Lifestyle interventions and risk factor modification reduce cardiovascular morbidity and mortality.  Coronary surgery patients who stop smoking are more likely to survive.

Rationale for prevention of CVD

 The mass occurrence of CVD relates strongly to lifestyles and modifiable physiological factors.

CVD Facts and Figures/ Irish Heart Foundation, July 2007  The underlying pathology is usually atherosclerosis, which develops insidiously over many years and is usually advanced by the time the symptoms occur.  Death, heart attack and stroke nevertheless frequently occur suddenly and before medical care is available, and many therapeutic interventions are therefore inapplicable or palliative.  Risk factor modifications have been unequivocally shown to reduce mortality and morbidity, especially in people with either unrecognised or recognised CVD.      

Recommendations for Heart Health

 Regular physical activity - at least 30 minutes 5 times a week  Healthy eating – lots of fruit, vegetables and fibre foods and less fatty foods and salt Healthy weight (body-mass index (BMI) of less than 25 kg/m) Blood pressure level lower than 140/90 mm Hg Blood cholesterol level below 5.0 mmol/L /190mg/dl  No use of tobacco Managing stress Regular check up with family doctor if family history of premature cardiovascular disease Appropriate prophylactic drugs when necessary.

Priorities for CVD prevention in clinical practice

1.

Patients with established coronary heart disease, peripheral artery disease and cerebrovascular atherosclerotic disease. 2.

Asymptomatic individuals who are at high risk of developing atherosclerotic cardiovascular disease because of: a) Multiple risk factors resulting in a 10 year risk of ≥5% now (or if extrapolated 3.

b) to age 60) for developing a fatal CVD event Markedly raised levels of single risk factors: Cholesterol ≥8mmol/l (320mg/dl), LDL cholesterol ≥6mmol/l (240 mg/dl), blood pressure ≥180/110 mmHg c) Diabetes type 2 and diabetes type 1 with microalbuminuria Close relatives of a) b) Patients with early onset atherosclerotic cardiovascular disease Asymptomatic individuals at particular high risk. Other individuals encountered in routine clinical practice. 4.

References

 The European Guidelines on CVD Prevention in Clinical Practice  Screening of family members of patients with premature coronary heart disease - Results from the EUROASPIRE II family survey - European Heart Journal (2003) 24, 249-257  Lifestyle and risk factor management and use of drug therapies in coronary patients from 15 countries - Principal results from EUROASPIRE II - European Heart Journal (2001) 22, 554-572. EUROASPIRE Study Group. Clinical reality of coronary prevention guidelines: a comparison of EUROASPIRE I and II in nine countries. Lancet 2001; 357:995-1001  European Cardiovascular Disease Statistics 2005 Edition - © British Heart Foundation, February 2005 - © European Heart Network, February 2005. 1 Fruit and vegetable policy in the European Union : its effect on the burden of cardiovascular disease, EHN, Brussels, 2005. 2 Irish Universities Nutrition Alliance (2001) North/South Ireland Food Consumption Survey. 3 Diabetes Federation of Ireland. Strategy paper. The way forward 2006-2010. www.diabetesireland.ie 4 Survey of Lifestyles, Attitudes and Nutrition (SLAN), 2003. 5 Perry I J, Collins A, et al. (2004). Established cardiovascular disease and CVD risk factors in a primary care population of middle-aged Irish men and women

Irish Medical Journal

, Volume 95 No 10

CVD Facts and Figures/ Irish Heart Foundation, July 2007

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