World Heart Day – 29 September: CPR – every second counts
27th September 2021
In this follow up blog, National FH and Lipids Programme Lead Dr Joe Chidanyika picks up from his last post about knowing your ABCs, inspired by the Euro 2020 cardiac arrest incident when Christian Eriksen from Denmark collapsed during a live televised football match.
This year World Heart Day falls on Wednesday the 29th September with an international theme of using our hearts to “connect” and find different and innovative ways to link people to heart health.
This is even more important given the global health crisis we have been living through, and that according to the World Health Organisation, Cardiovascular Disease (CVD) still results in 18.6 million deaths a year.
CVD has many causes: from smoking, diabetes, high blood pressure and obesity, to air pollution.
CVD key facts in the UK
- 6 million people in the UK live with heart and circulatory diseases.
- The British Heart Foundation (BHF) estimates that in the UK more than half of the population will get a heart or circulatory condition in their lifetime.
- Heart and circulatory diseases cause a quarter of all deaths in the UK; that’s more than 160,000 deaths each year – or one death every three minutes.
- 5 million people are estimated to have atrial fibrillation in England
- There were 24,700 preventable CVD deaths in 2001 but in there were just 13,400 preventable CVD deaths in 2019
- 20% increase in alcohol-specific deaths between 2019 and 2020 in England
It is important to note that, in the context of the pandemic, CVD patients are more susceptible to severe COVID-19. Diseases that affect heart health or heart function include hypertension and diabetes, acute coronary syndrome, heart failure or myocardial infarction – the condition that Christian Eriksen suffered with.
Risk factors
There are many risk factors associated with CVD, with some, such as family history, unmodifiable, but other risk factors, like high blood pressure, being overweight or a lack of physical activity, can be modified with treatment or the adoption of healthier lifestyles. Most people might not necessarily develop CVD if they do have some of these risk factors. However, the more risk factors we have, the greater the likelihood of developing CVD, and unless we take action and work to prevent our risk factors, we continue compromising our heart health.
The C in our CVD ABC’s stands for raised cholesterol and is estimated to cause about 2.6 million deaths (4.5% of total) globally and is implicated in heart diseases and stroke statistics.
It is estimated that people who are not active enough run a 20–30% increased risk of mortality from any number of health-related causes. At least 3.2 million deaths are attributable to insufficient physical activity each year across the globe. Around 150 minutes of moderate physical activity per week reduces the risk of heart disease by 30% and the risk of diabetes by 27%.
The Eriksen effect
For the footballer Eriksen, risk factors other than physical inactivity would have been at play when he suffered that cardiac arrest, given that he is an elite sportsperson. However, such a horrific and indelible incident was a positive catalyst to normalise how the world over can talk about and promote heart health. In Denmark alone, media reports suggest that there was a seven-fold increase seen in Cardio-Pulmonary Resuscitation (CPR) related education and training sign up as a result of that incident, enabling citizens to be first responders to assist heart attack victims. This positively put into perspective how important that us, as everyday people, can make a difference if ever called upon to perform CPR. Every second counts when someone suffers a cardiac arrest, so the more of us that know how to perform CPR, the more lives that can be potentially saved.
Evidence suggests that the chances of surviving a heart attack increase from less than 10% to over 70% if the victim receives CPR and a shock from a defibrillator before the ambulance arrives. Eriksen’s collapse during the match against Finland has prompted calls around the world for more CPR training and for defibrillators to be more available, not least at sports grounds and training facilities. Clearly with CPR training, the only wrong thing we can all do is to not do anything at all when one has a cardiac arrest, as each second does count.
The BHF suggests that between June 13 and 18 this year, their website had over 133,320 views of its CPR and defibrillator website pages, up from 6,942 from June 6 to 11. After the charity’s new advert with football legend Vinnie Jones aired, there was another leap in views of the life-saving information, of 82%. It is more sobering when estimates suggest that just one in ten people survive an out of hospital cardiac arrest in the UK, and every minute without CPR and defibrillation decreases a person’s chances of survival by up to 10-15%. However, in countries where CPR is widely taught and defibrillators are more readily available, survival rates are arguably up to even three times as high. So it is imperative that all this interest evidenced by BHF and other partners is capitalised on and we continue to promote heart health, not just during World Heart Day or next month’s October: National Cholesterol month, but all year round.
Last year’s National Cholesterol Month saw HEART UK lead on an ambitious national push to have a record 1 million cholesterol related conversations and how best to manage this CVD condition. We are looking forward to supporting this year’s national cholesterol campaign starting in a few days.
Cholesterol key facts
- Around 40% of men and 45% of women have a diagnosis of high cholesterol.
- High cholesterol can be caused by many different factors, like having too much saturated fat in your diet or smoking, or it can be a result of other conditions, like kidney or liver disease.
- The National CVD Prevention Programme is aiming for 75% of people aged 40 to 74 to have received a formal CVD risk assessment with a cholesterol test within the previous 5 years by 2029.
- Prescribing levels of NICE approved novel therapies which are evidenced based to reduce high cholesterol have increased year on year since publication of their NICE appraisal for products such as PCSK9i and higher statins.
Impact of the national lipid programme to date
The current national lipids and FH programme launched last October has seen all 15 AHSNs closely working with their stakeholders to ensure a consistent application or use of the national NICE endorsed lipids and FH pathway to enhance the optimisation of lipids for patients who are both at risk of CVD or have already have had CVD events like heart attack. Key achievements to date for this programme include
- An agreement of metrics for the delivery of the programme nationally in collaboration with our key stakeholders.
- The development of a Community of Practice approach from AHSNs and our stakeholders, supported by a suite of educational learning and training resources centrally hosted by HeartUK to improve workforce capacity and capability.
- Successfully support of provider trusts to access Pathway Transformation Funding to improve the spread and adoption of new novel therapies around lipid optimisation.
- Working in collaboration with wider stakeholders to achieve the NHS CVD LTP ambitions to prevent avoidable CVD deaths.
- Funding opportunity for seven AHSN sites to pilot the Child Parent Screening initiative to improve the detection of Familial Hypercholesterolemia (FH) from current 4% to 15% of the eligible English population