2023-06-26 08:36:59
Cardiovascular diseases are the leading cause of hospitalization and death in Spain. Faced with this great challenge, a review is necessary to detect the main challenges and possible opportunities to improve cardiovascular health.
Towards better cardiovascular health in Spain. Image courtesy of FarmaIndustria
During the year 2021, 326 people died every day in Spain due to cardiovascular disease (CVD), according to data from the National Institute of Statistics (INE).
These figures place CVD as the leading cause of hospitalization and death, making it urgently necessary to improve cardiovascular health.
Spain is one of the few EU countries that has recently published a national strategy fully focused on cardiovascular health (SCV).
On these bases arises the report “Towards a better cardiovascular health in Spain”, prepared by Farmindustria and the result of a debate between the key agents of these pathologies, from both public administrations and the academic, clinical and pharmaceutical industry.
The main objective of this study is preserve and improve cardiovascular health.
The numbers of poor cardiovascular health
According to INE data, about 120,000 people died in 2021 as a result of a cardiovascular disease or problem.
Las women are generally more affected than men since each year almost 7,500 more women die from these pathologies than men.
Furthermore, the data shows that economic costs of cardiovascular diseases are on the rise, with economic expenses increasing by at least 20% between 2014 and 2020.
The importance and the need to actively address evolving and increase in cardiovascular problems have led to the elaboration of the Cardiovascular Health Strategy of the National Health System (ESCAV) as a result of which the key factors are being analyzed to improve cardiovascular health.
Key challenges to work on to improve cardiovascular health in Spain
Despite the fact that the figures are quite negative, the truth is that between 1990 and 2019 Spain presented the lowest death rate by Cardiovascular Diseases (CVD) among the 27 countries of the European Union.
However, the problems of these pathologies continue to be one of the main concerns since it constitutes the first cause of death. Furthermore, the prevalence has begun to stagnate.
To face the problem, the report includes the most important challenges to work on.
1. Promotion of early diagnosis and prevention of cardiovascular diseases
As in Europe, the management of cardiovascular diseases has focused mainly on treatment, relegating prevention to the background. The lack of early diagnosis and the lack of prevention are, according to the study, the main problems.
Since there is no systematic program for the early diagnosis of CVD and its risk factors, a significant percentage of the disease burden is never detected.
An example of the lack of prevention is exposed by the study when investigating the treatment of cholesterol problems.
Just two-thirds of Spanish cardiology units offer cardiac rehab y only one in ten people are aware of their ideal cholesterol levels.
The increasingly aging population requires greater efforts to improve prevention and early diagnosis.
The report concludes by noting that most underlying cardiovascular diseases They are not discovered until there is a acute episode.
2. Improve the collection, distribution and management of cardiovascular data
The collection and collection of data is not homogeneous and it is subject to large differences by communities.
Besides, the data that are collected on cardiovascular diseases pose a challenge for analysis, since they are not standardized and they are also not shared or exported to facilitate research.
Only 6 of the 19 autonomous communities collect CVD-specific data through registries. Of them, only 3 (Galicia, the Basque Country and Catalonia) use the data with a purpose beyond reporting.
The regionalization of the Spanish system accentuates the problems related to the data infrastructure design and maintenancecomplicating their compatibility between regions, communities and countries.
Collection of data on cardiovascular diseases in Spain by Autonomous Communities. Graph available in the report provided by FarmaIndustria.
3. Achieve equality in relation to Cardiovascular Diseases
There are important inequalities in CVD treatment.
Geographic inequalities: risk factors and in-hospital mortality vary greatly between regions. These differences are evident mainly in the awareness and in access to quality prevention which does not occur equally in all communities.
Socioeconomic inequalities: people from a less privileged socioeconomic group are more exposed to metabolic risk factors such as hypertension, high cholesterol, diabetes or obesity.
Inequalities by gender: Cardiovascular diseases rank as the leading cause of death in women, the genus most affected by these pathologies. There are specific risk factors for the female sex such as preeclampsia, gestational diabetes and cardiotoxicity related to breast cancer treatment. Inequalities by Autonomous Communities in mortality caused by CVD. Graph available in the report provided by FarmaIndustria.
Better cardiovascular health in Spain is possible
The challenges related to CVDs are complex and interconnected. The study has focused on highlighting the following work areas face to improve cardiovascular health:
Identify people at risk and reconfigure secondary prevention pathways.
Promote correct collection, distribution and management of data related to cardiovascular diseases.
Provide more equitable access to early diagnosis and prevention.
Key opportunities to implement successful cardiovascular health improvement
Synergies and cooperation at European level
This Spanish review prepared by FarmaIndustria also offers to Europe useful lessons on equity in the treatment, diagnosis and prevention of cardiovascular diseases.
Many countries in Europe share the regional decentralization model that increases the differences between communities and regions. Spain explicitly includes equity considerations in its national MCS strategy, something that other European countries could follow.
On the other hand, the proposals raised at the European level could lead to important improvements and advances at the national level. Also, EU initiatives based on Real World Evidence (RWE) would be essential to boost potential local investment.
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