UK facing heart valve 'epidemic'Poorly prepared for rising number of patients
The UK is facing an epidemic of valvular heart disease and is poorly prepared to deal with it, experts say.
By 2018, an estimated four million people in the UK are expected to have diseased heart valves, caused by a rapidly ageing population.
European and US data indicates that more than 13 per cent of those aged 75 and above already have valvular heart disease (VHD).
The condition can be associated with a great deal of ill health and poor quality of life. It is also expensive to treat, largely because a defective valve is often not picked up until it is too late to treat successfully.
Data from the latest National Adult Cardiac Surgery Database for Great Britain and Northern Ireland shows wide variation in the provision of treatment for VHD.
More than a third of those undergoing surgery to repair defective heart valves had advanced disease, significantly increasing their likelihood of complications, death, and ineffective symptom relief, said the UK surgeons in the journal Heart.
“These observations suggest that both initial diagnoses and subsequent follow up are currently inadequate and that patients are routinely referred late in the natural history of the condition, beyond the window where surgery is of maximum benefit,” they said.
They said that ageism and sexism also seem to be factors, with twice as many men undergoing aortic valve replacement as women, and patients over the age of 75 with moderate to severe disease half as likely to be treated surgically as their younger counterparts.
“Advancing age is often used to justify the decision to withhold surgery, but suitably selected patients may derive considerable improvement in symptomatic burden and overall quality of life, following successful intervention,” the authors said.
The experts from Oxford’s John Radcliffe Hospital, London's St Thomas’ and the University Hospital of South Manchester called for specialist VHD centres to be set up, staffed by specialists with access to the right screening tests and equipment.
They concluded: “VHD has been relatively neglected by politicians, health economists and even by cardiologists.
"National programmes already exist for heart failure and coronary disease. A similar coordinated approach to research, education, and clinical management is now needed to ensure improved outcomes for all patients with VHD.”
Professor Peter Weissberg, medical director at the British Heart Foundation, said: “The authors of this paper are right to point out that the NHS will need appropriately skilled health care professionals to identify and deal with patients of all ages - particularly the elderly - with valve disease.
“It is well established that patients with all types of heart disease have a better chance of survival and quality of life when managed by an expert cardiological team.
“It is essential that all hospitals maintain and indeed expand their expert cardiac services over the coming years to avoid the financial and health costs of not dealing with the changing pattern of heart disease in an expert and timely manner.”
This article was published on Tue 14 December 2010
Image © Cecilia Lim - Fotolia.com
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