Associate feature: Preventing heart and circulatory disease in our communities

As many as half a million adults in Scotland with high blood pressure are undiagnosed. That’s up to 500,000 people unknowingly living with a condition that is associated with around half all of heart attacks and strokes.

High blood pressure is the leading modifiable risk factor for heart and circulatory diseases in Scotland.

We need to find and implement new and more effective ways to prevent, diagnose and treat high blood pressure as well as other risk factors, such as high cholesterol.

At the beginning of this year, the British Heart Foundation (BHF) Scotland launched its strategy and vision for the future of heart disease services in Scotland, from prevention through to care.

One key to this vision is urgent improvement in the diagnosis and management of the risk factors. A possible solution to this is a community-based model that has been shown to work internationally.

The Canadian Cardiovascular Health Awareness Programme increased awareness and diagnosis of high blood pressure through partnerships with primary care providers, community pharmacists, community groups and locally trained volunteers acting as peer health educators.

The programme reduced hospital admissions for stroke, heart attack and heart failure by 9 per cent. It also allowed 57 per cent of people with high blood pressure to be treated effectively – this compares to around a quarter in Scotland.

If Scotland was to reach Canadian levels, it is estimated that 17,000 heart and circulatory events, including heart attacks and strokes, could be avoided over a ten-year period.

Beyond diagnosis, we also need to ensure patients are supported to manage risk factors more effectively.

Central to this is the use of advancements in data and technology already available to us. It is now possible for people to self-monitor their blood pressure or cholesterol using devices at home.

This information can then be transmitted to alert healthcare professionals to support patients when blood pressure, for example, is consistently high.

Key to this, however, is to ensure that all adults in Scotland have equal access to such monitoring devices, regardless of geography or socioeconomic group and there must also be efforts to supply them to those who might not be able to afford or access them.

We must also make sure that through the new SPIRE data system, our primary care professionals have access to all the necessary data to support their patients.

Currently, it is difficult and time-consuming for GPs to ensure all patients with a diagnosed risk factor are on the appropriate level of treatment.

This is particularly true for those with atrial fibrillation, one of the most common forms of abnormal heart rhythm.

SPIRE allows individual or clusters of medical practices to identify patients who may not be currently receiving appropriate treatment and to adjust it where necessary - action that could help prevent many heart and circulatory events.

For all of these issues, it is crucial that the NHS urgently utilises the models, technology and data systems that are already available. A new heart disease strategy would provide the opportunity to drive such a change.

As we approach the Holyrood election in May, BHF Scotland wants to see all political parties commit to a new national heart disease strategy backed by the resources we need to create effective and impactful improvement in the prevention of heart and circulatory disease for those living with risk factors.

Jon Roden is policy and public affairs manager at British Heart Foundation (BHF) Scotland. This article was sponsored by BHF Scotland.