Rallying policymakers and health systems to prioritise ASCVD

Rallying policymakers and health systems to prioritise ASCVD
© iStock/Eoneren

Neil Johnson, Executive Director of the Global Heart Hub posits the need to take stronger action when it comes to preventing and managing Atherosclerotic Cardiovascular Disease.

Despite claiming significantly more lives than cancer, the leading driver in cardiovascular deaths remains largely unheard of by the public and under-prioritised by governments. Atherosclerotic Cardiovascular Disease (ASCVD) refers to the build-up of fatty deposits in the arteries, which, if left untreated, can lead to strokes and heart attacks; it accounts for 85% of heart-related deaths. Neil Johnson, Executive Director of the Global Heart Hub, spoke to Lorna Rothery about the need to shift our attention to ASCVD and urge policymakers to act.

Speaking at the European Parliament last year, you referred to ASCVD as the ‘cancer of the heart world’, yet it is a condition that many within the general population are unfamiliar with. How can discussions on CVDs be reframed to encourage greater public awareness and political action?

ASCVD is the predominant cause of suffering and mortality around the world. It is a slow, insidious condition that often goes unnoticed until it is too late. In fact, many people are not diagnosed until they experience a major cardiovascular event – such as a heart attack or stroke – at which point they will be given treatment if they are lucky. We need to reframe the discussions by shifting the focus from treatment to prevention, early detection, and management of risk factors. 80% of premature cardiovascular deaths are preventable through existing interventions.

Why has ASCVD not been prioritised on the EU healthcare agenda, and how do you propose that changes?

I believe we have accepted a position of complacency when it comes to heart disease. Science has certainly advanced when it comes to the detection, and management of risk factors and treatment; today an individual can have a heart attack, receive a stent and be out of the hospital in a matter of days. But where we are failing is the lack of commitment to drive an effective policy on prevention. This is in contrast to the area of cancer, for instance, where there is an EU action plan and guidance for Member States to achieve a common set of goals. The same now needs to be done for cardiovascular disease, and this starts with prevention programmes focusing on the main risk factors for ASCVD which include especially elevated LDL-Cholesterol (also known as bad cholesterol). Screening for high cholesterol needs to become more systematic – it will save countless lives, improve the quality of life for many, and in the long run, it will enable savings for healthcare systems. Secondary prevention programmes for those who have had a cardiac event, such as cardiac rehabilitation and therapeutic optimisation, need to be urgently prioritised. Bringing attention to the urgency of the burden of ASCVD is where we need to bring the highest level of public and political attention.

© iStock/Milko
80% of premature cardiovascular deaths are preventable through existing interventions

Can you tell us more about Invisible Nation, the programme launched last year by the Global Heart Hub, and what it hopes to achieve?

In contrast to its significant prevalence, ASCVD remains a health challenge that is hidden in plain sight. Invisible Nation aims to expose and respond to the realities of ASCVD. Working with a global network of heart patient organisations, we engage stakeholders from across the health ecosystem to ignite conversation, inspire action, and activate systemic change to make the burden of unmanaged ASCVD un-ignorable.

What role do patient organisations and alliances, such as the Global Heart Hub, play in ensuring governments prioritise action to better manage and prevent ASCVD?

From a citizen and patient perspective, there are a lot of unmet needs, starting from the lack of understanding of heart diseases, and ASCVD in particular. Heart patient organisations around the world are doing incredible work to support, empower and educate patients to advocate for themselves in their own healthcare. Today, we have access to much more information and knowledge than we had 20, even ten years ago – we also understand the preventable nature of this disease. Patients are therefore increasingly more likely to be engaged and able to express their preferences. It is vital we include their lived experience in conversations that advance cardiovascular care. In my view, the patients’ voice could serve as the disruptor that improves cardiovascular health, and patient organisations carry this voice to where it can be heard. An example of this in practice is the Global Cholesterol Action Plan launched by the Global Heart Hub last November. Aimed at activating change among all stakeholders to reduce the impact of unhealthy cholesterol levels, the plan is the communities’ collective call for governments to prioritise prevention and ultimately, reduce the tremendous burden of ASCVD on individuals, on society, and on the healthcare system.

Neil Johnson
Executive Director
Global Heart Hub

This article is from issue 24 of Health Europa Quarterly. Click here to get your free subscription today.


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