Almost 100,000 more people have died with cardiovascular disease in England than expected in the three years since the pandemic began, a new analysis from the British Heart Foundation (BHF) shows.
And pharmacy leaders have commented that the findings demonstrate the need for 'life-saving' interventions based in community pharmacy.
Data from the Office for Health Improvement and Disparities (OHID) shows an average 500 additional deaths a week involving cardiovascular disease since the pandemic began.
The BHF said that a range of factors are likely to contribute to the figures, including Covid-19 itself, extreme pressure on the NHS and disrupted healthcare as well as changing patient behaviour and worsening population health.
The analysis found 96,540 excess deaths involving cardiovascular disease between March 2020 and May this year – more than any other disease group.
The charity noted that the number of patients waiting for time-sensitive cardiac care was at a record high of nearly 390,000 at the end of April in England, while average ambulance response times for heart attacks and strokes have consistently been above 30 minutes since the beginning of 2022.
Rates also changed over time with Covid-19 infection driving high numbers of excess deaths involving cardiovascular disease in the first year where more than 50% of the higher than expected deaths occurred.
Excess deaths involving cardiovascular disease then dropped significantly in the second year of the pandemic before increasing again in year three by 13,000.
In the third year of the pandemic, the number of excess deaths involving cardiovascular disease outnumbered the number of deaths where cardiovascular disease was mentioned but where Covid-19 was the underlying cause by around 19,400 deaths, the BHF said.
The charity warned the UK Government must take charge of the increasingly urgent cardiovascular disease crisis.
Dr Charmaine Griffiths, BHF chief executive, said: ‘It is deeply troubling that so many more people with cardiovascular disease have lost their lives over the last three years. My heart goes out to every family who has endured the pain of losing a loved one, all too often in distressing circumstances.
‘For years now, it has been clear that we are firmly in the grip of a heart and stroke care emergency. If little changes, we could continue to see a sustained rise in death rates from cardiovascular conditions that undoes decades of scientific progress to reduce the number of people who die of a heart attack or stroke.’
People who have had Covid-19 may be at increased risk of developing cardiovascular complications in the following year, according to a study published in 2022.
But Dr Sonya Babu-Narayan, associate medical director at the BHF and consultant cardiologist, said Covid-19 no longer fully explains the significant numbers of excess deaths involving cardiovascular disease.
‘Other major factors are likely contributing, including the extreme and unrelenting pressure on the NHS over the last few years.
‘Long waits for heart care are dangerous – they put someone at increased risk of avoidable hospital admission, disability due to heart failure and premature death. Yet people are struggling to get potentially lifesaving heart treatment when they need it due to a lack of NHS staff and space, despite cardiovascular disease affecting record numbers of people.’
A government spokesperson said that it was cutting waiting lists and ambulance response times, increasing staff and improving access to blood pressure and health checks.
‘We know there is more to do which is why we are consulting on a Major Conditions Strategy to tackle cardiovascular disease – including strokes and diabetes – and we have opened 108 community diagnostic centres that have delivered over 4 million tests, scans and checks including for those with cardiovascular disease.
‘The government is also working with NHS England to combat some of the causes of cardiovascular disease, with schemes to support increased physical activity, reduce obesity rates and encourage people to stop smoking.’
Helga Mangion, policy manager at the National Pharmacy Association, highlighted the BHF's belief that the Covid pandemic had disrupted the detection and management of conditions that put people at risk of heart disease, contributing to excess deaths.
'This is a reminder that pharmacy-based interventions like hypertension case finding are life-saving. Pharmacy support to quit smoking, manage weight and optimise medicines use are also vital elements in preventing cardiovascular disease,' she said.
And Malcolm Harrison, chief executive of the Company Chemists' Association, said that 'part of the answer' to combating the 'concerning' number of excess deaths and 'devastating' impact of cardiovascular disease would be 'making community pharmacy the first port of call for cardiovascular care'.
In the first year of the NHS Community Pharmacy Blood Pressure Check Service, community pharmacies delivered nearly 600,000 checks, estimated to have prevented over 600 future heart attacks and strokes.
And a recent hypertension paper published by the CCA calculated that by 2026 community pharmacy will deliver 15m blood pressure checks, preventing 15,000 heart attacks and strokes.
'As ever the potential of the sector is underutilised', said Mr Harrison.
In its primary care delivery plan, the government recently committed to expanding the community pharmacy hypertension service, which Mr Harrison described as a 'stamp of approval from government'.
'However, we believe that with investment, we can go further and faster. We envisage that community pharmacy could, over time, be the go-to-place for end-to-end management of cardiovascular disease,' he added.
Alastair Buxton, Director of NHS Services at Community Pharmacy England (CPE), shared his concerns about the 'tens of thousands of preventable deaths from cardiovascular disease (CVD) since the start of the COVID-19 pandemic'.
He said that CPE shared the BHF's desire to see more action on preventing the causes of CVD, and added that, subject to appropriate funding being in place, community pharmacy teams were well placed to play a role in this.
'With more than 1.1 million people receiving a heart blood pressure check in their local pharmacy since October 2021, the Hypertension Case-Finding Service has already begun making a big difference to the health of individuals and supports the NHS Long Term Plan’s ambition for prevention of cardiovascular disease.'
Labour’s shadow health secretary Wes Streeting said that the BHF's 'tragic findings' were 'the result of 13 years of Conservative understaffing the NHS, and failure to provide more care in the community and prevent disease'.
He added: ‘The mission of the next Labour government will be to cut deaths from heart disease and stroke by a quarter within a decade. We’ll achieve it by training the staff the NHS needs to treat patients on time again and reforming the service to make it fit for the future.’
A version of this article was first published on our sister site, Pulse.
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