10 Nov 2023

'One in three will die from heart disease' - Specialists call for national action plan

5:51 am on 10 November 2023
Illustration of human heart beat diagram

The article says one in eight health dollars were spent on heart disease and stroke. Photo: 123RF

Heart specialists warn New Zealand's progress in preventing and treating heart disease and strokes is flat-lining and the death rate could rise in future.

Heart Foundation medical director and associate professor Gerry Devlin, one of a group of clinicians behind the Call to Action in the New Zealand Medical Journal today, said heart disease was killing 10,000 New Zealanders a year.

"One in three of us will still die from heart disease or stroke, and cardiovascular disease is the leading cause of health loss in our community.

"So our call to action is to the incoming government to get on and implement the heart health action plan."

Failing to do so, would cost everyone, he said.

As the article noted, one in eight health dollars were spent on heart disease and stroke, "and the wider costs from disability and death run to hundreds of millions".

The Heart Health Action Plan:

  • Reduce the risk of heart disease through prevention (promoting healthy eating, physical activity, smoking cessation)
  • Early detection - one in five adults have high blood pressure but fewer than one in three of them have it well controlled
  • Timely access to evidence-based treatment and support. "People are often not able to access the health system until forced to by an emergency and even then delays in seeking and receiving care are common ... A third of New Zealanders who had a heart attack in 2022 waited more than two hours to call for help."
  • Increase survival rates for out-of-hospital cardiac arrest - currently only one in ten survive - by boosting CPR education and making community defibrillators available
  • A more transparent and accountable health system
  • Support a world-class health workforce to translate research into practice

Associate Professor Devlin said of the 10,000 deaths each year, a quarter were avoidable, rising to half for Māori and Pacific people.

Those living in rural areas and regions with high levels of deprivation were also dying in greater numbers.

"That's not fair, we need to develop a robust health system that actually addresses some of those issues, and improves some of those regional inequities we see with access to specialist opinions and diagnostic services.

"For instance, where I work in Tairāwhiti, there's 0.5 of me as a cardiologist and we've had one full-time vacancy for the last 10 months that we cannot recruit to, and that impacts dramatically on access to services in Tairāwhiti."

Dr Gerry Devlin.

Heart Foundation medical director and associate professor Gerry Devlin. Photo: Supplied / NZ Heart Foundation

Nationwide, there are 160 cardiologists of which only about 2.5 percent are Māori or Pacific, and 18 percent are women.

Devlin said since 2020 - when the Heart Foundation first posted its national action plan - 30,000 people have died. Seven thousand of those deaths were preventable.

"We've had a 75 percent reduction in fatal heart attacks since 1968 when the Heart Foundation was set up.

"But I think there's a sense of 'been there, done that', and we're not done.

"What's happening in New Zealand and around the world is those trends have actually bottomed out and are coming up again and we're going to see more people dying of heart disease in the future."

The causes of heart disease were changing, with good progress on smoking cessation, but diabetes on the rise, and piecemeal access to cost-effective treatments.

With the current health sector restructuring, the country had a "once in a generation opportunity" to fix the problem, the specialists wrote.

The plan should aim to reduce the rate of avoidable disease and deaths by at least 50 percent by 2050, and by 2040 for Māori.

"Given the scale of avoidable heart disease and avoidable heart health inequity, much of it due to people simply not accessing existing treatment options, there is no excuse not to deliver a national heart health action plan."

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