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Last Updated:  Friday, 21 February, 2003, 18:26 GMT
Heart care 'lottery' in Europe
Obese man
Obesity is a risk factor for heart disease
The risk of dying from heart disease varies dramatically across Europe, a survey has found.

Around four million people die each year in Europe from heart disease, accounting for 40% of deaths in under-74s.

The UK has one of the highest death rates for heart disease in western Europe, topping the table alongside Ireland and Finland, although rates are falling.

The survey by the European Society of Cardiology (ESC), identified variations in heart care across Europe.

It found that the UK carries out fewer procedures than other countries, such as Germany, but prescribes more cholesterol-lowering medication than Belgium.

But it showed death rates were highest amongst Eastern and Central European countries, where they have increased significantly.

Mediterranean countries have the lowest death rates from heart disease, with France, Spain and Israel seeing fewer than three deaths per 1,000 inhabitants.

Scandinavian countries are seeing the fastest decrease in death-rates.

Heart disease will become the number one killer within 10 years
Professor John Martin, European Society of Cardiology
Russian men and women aged 35 to 74 are eight times as likely to die from heart disease as men and women in France.

The death rate in Ireland is twice that of Italy.

Guidelines

Although the UK carries out fewer heart operations than many other European countries, the number of coronary artery bypass grafts has doubled over the last 10 years, and the number of angioplasties has risen by around 40% in the past year.

The ESC survey also looked at how many doctors followed national guidelines for assessing heart disease risk.

Only a fifth of doctors in France and Poland follow national guidelines compared to one third of doctors in Germany and Italy.

In the UK, where there is a National Service Framework for coronary care, and in Spain, three quarters of doctors adhere to the guidelines.

Professor John Martin, a cardiologist at University College London and a spokesperson for the ESC, told BBC News Online: "We need to have an objective assessment, by doctors not politicians, to say from the patient's point of view 'this is what should be happening'."

"For example, doctors in Germany carry out more angioplasties. Either the German government is wasting money, or we're not doing enough of the procedures.

"My gut feeling is that the Germans are doing too many, and the UK is doing slightly too few."

He said the ESC had approached the European Commission, proposing an EU-wide study.

'Best practice'

Professor Martin warned that, as well as addressing the heart disease levels in existing EU countries, attention had to be focussed on prospective members in Eastern European, where death rates were two to three times as high as in the UK.

He added: "Changes in lifestyle and appropriate use of medicines have started to decrease heart disease in Europe.

"However, the steadily ageing European population means that this positive effect will be offset in the near future unless drastic action is taken.

"On a global scale, the World Health Organization predicts that heart disease will become the number one killer within ten years."

In a bid to bring heart care in line across Europe, the ECS has launched a "Heart Plan for Europe".

Professor Jean-Pierre Bassand, ESC President, said: "It involves sharing best practice between countries, adopting a common strategy for disease prevention, and encouraging governments to provide more support at a national level towards addressing the problem."

Belinda Linden, head of medical information at the British Heart Foundation said: "Death rates from coronary heart disease (CHD) in the UK are falling, but we must not be complacent as we still have one of the highest death rates in Western Europe.

She said patients and doctors had to work together to tackle lifestyle factors.

She added: "The good news is that treatments for heart disease are becoming more available. There has been a significant increase in the use of cholesterol lowering drugs and the number of surgical interventions - and this trend must continue.

"However, with more people now living with CHD, the increasing burden on the NHS in the future must be seriously considered."



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