Promoting healthy hearts
Annie SCHREIJER-PIERIK MEP Member of European Parliament’s ENVI Committee
Where we are now on heart failure is not acceptable
eart failure is a widely misunderstood but devastating chronic condition. Nearly 15 million people in Europe have heart failure, and this number is increasing. Up to one in five people are at the risk of developing a heart failure at some point in their life. Yet, awareness remains worryingly low. For example, just 3 percent of the general public can correctly identify all three key symptoms – extreme breathlessness, fatigue and swollen ankles. We cannot accept such low awareness of symptoms for such a common condition. Unfortunately, this poor understanding of heart failure often allows the condition to progress significantly before diagnosis and start of treatment. Even a delay of four to six hours after onset of symptoms can increase the risk of death significantly. This is just one of the reasons why I co-authored the Written Declaration 110/2016 on heart failure. We can do a lot to improve quality of life and life expectancy for people living with heart failure. We need to provide better support and care across all aspects of their lives.There is no cure for heart failure, so treatment aims to stabilise and manage symptoms to prevent
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progression.Information and support are essential in enabling enable people to adhere to treatment and make important lifestyle changes. We know what to do with heart failure, but quite often healthcare systems do not deliver it. The same could be said of many diseases, but there is a particularly compelling case for heart failure when we consider health systems’ readiness for the future. Heart failure is a chronic condition where the heart cannot pump enough blood to support the needs of other organs in the body. It is often (but not always) a result of many years of living with other cardiovascular diseases. The most common causes of heart failure include coronary heart disease, heart attacks, congenital heart defects and damaged heart valves. The numbers of people living with heart failure, as well as other conditions that can lead to it, are certain to rise. In general, there has been an increased focus on prevention of non-communicable diseases across Europe. However, we need to go further and see complex conditions and comorbidities as an essential aspect of health system sustainability. With an ageing European population, health strategies at all levels must recognise the value of prevention and promotion of wellbeing for those
with existing chronic conditions (eg, secondary prevention). These must be seen equally to health promotion and primary prevention in the general population. Therefore, heart failure is of huge relevance. Not only does it have a significant human and economic burden, but it can also act as a model for other chronic disease management. If we can get it right in heart failure, we will be well placed for many other chronic conditions. In heart failure, patients and clinicians must work together to succeed, but to do this, there must be significant support from politicians and decisionmakers. Investment in delivery and organisation of care,such as specialist nursing, self-management, education, palliative care and better care transitions, are essential and overdue. Where we are now on heart failure is not acceptable – and this is a leadership challenge. The European Parliament must continue to keep heart failure on its political agenda. It is our responsibility to ensure that people with heart failure receive the high-quality care and support that they need, and to build a common cause with other non-communicable diseases. Now more than ever, heart failure needs a seat at that table.