1.8m Australians missing out on recommended heart treatment

Heart Foundation modelling estimates that 1.8 million Australian adults are not being prescribed the recommended blood pressure-lowering and lipid-lowering therapy to manage their risk of heart attack and stroke.

The modelling finds that treating high-risk patients with guideline-recommended blood pressure and cholesterol-lowering medicines could prevent more than 103,000 heart attacks, strokes and heart-related deaths, and save almost $1.8 billion in healthcare costs over the next five years. Treating all patients at high risk of heart attack and stroke over the next five years would allow Australians to gain an extra 45,580 years lived in good health.

Heart Foundation Risk Reduction Manager Natalie Raffoul said the findings were a wake-up call for the community, health professionals and government about the number of Australians missing out on guideline-recommended treatment.

“This modelling reinforces data that shows that high-risk people are consistently missing out on life-saving pharmacological therapy. To tackle this issue, we need a more systematic approach to absolute cardiovascular disease (CVD) risk assessment like the widespread uptake of Heart Health Checks,” Raffoul said. “Validated calculation of a person’s CVD risk during a Heart Health Check allows therapy to be targeted to people who would most benefit from it.”

Medications to lower blood pressure and cholesterol are currently recommended in adults at high risk of CVD and can significantly reduce an individual’s chances of having a heart attack or stroke in the future.

“Pharmacological lowering of blood pressure, even in people without existing CVD, reduces the incidence of coronary heart disease events by up to a quarter and a 1 mmol/L reduction of LDL cholesterol is associated with a 20 to 30% reduction in coronary heart disease events,” Raffoul said.

The Heart Foundation has calculated, for the costs of detecting, managing and treating patients at high risk, the net benefit in healthcare savings alone would be $130 million.

The heart health body is calling for Heart Health Check MBS items 699/177 to become permanent to ensure people at risk of heart, stroke and vascular disease are detected early and treated according to recommended guidelines. The Heart Health Check is the first preventative health assessment MBS item to incorporate absolute CVD risk calculation and facilitate yearly assessment, with the Heart Health Check Toolkit — developed by the Heart Foundation and released last month — designed to make the Heart Health Check easier to implement in general practice.

“Through the guidance of our primary care Expert Advisory Group, we know that easy-to-use tools and resources that make the Heart Health Check fast and simple to deliver are essential.

“The Toolkit offers pre-populated assessment and management templates for GPs and practice nurses to collect CVD risk factor information and support patients to manage their risk,” Raffoul explained. “It also includes a range of resources that can be used by general practices to help engage patients in their heart health.”

In another initiative, the Heart Foundation has teamed up with the University of Technology Sydney (UTS), announcing a five-year strategic partnership to improve heart-disease treatment and care for all Australians. An initial focus of the partnership will explore ways in which the Heart Foundation can improve its programs of support and care for people living with heart disease.

“This work is more vital than ever before, because while the number of Australians dying from heart disease is declining, there has been an increase in people living with the condition,” Heart Foundation Group CEO Adjunct Professor John Kelly said.

“Every day, around 440 Australians are treated in hospital for heart disease. Across the country, approximately 580,000 people live with the daily pain, discomfort and challenges of these conditions. For more than 60 years, the Heart Foundation has been committed to providing innovative, evidence-based programs to support people living with heart disease, as well as their families and carers.

“Our collaboration with UTS is part of this commitment. It is allowing us to take a fresh look at the ways in which we are currently engaging with health professionals and their patients to provide support and care, and investigate quality-of-life improvements that will provide better outcomes for people with heart disease,” he said.

Project lead and Associate Dean with the UTS Business School Professor Michelle Baddeley says that the research collaboration between UTS and the Heart Foundation is already delivering important and impactful insights.

“The first phase, now completed, has focused on the landscape of the heart-health services currently available to support people living with pre-existing cardiovascular conditions by visually mapping Australia’s heart-health landscape and the Heart Foundation’s role within it.

“The project’s ongoing research, to be carried out by an embedded PhD student, is exploring in more depth the role of formal and informal services and relationships supporting heart patients’ health and wellbeing, building important policy insights to ensure that Australians with heart conditions get the best care and support.”

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