EuroHeart 2009

New research points to huge inequalities in both national prevention policies and levels of cardiovascular mortality seen across the EU

Research that highlights striking differences across different countries in Europe both in terms of national prevention policies and cardiovascular mortality is being presented today (September 10, 2009) by the EuroHeart mapping project at a major European Conference 'Combating heart disease and stroke: Planning for a Healthier Europe'.

The event, held at the Residence Palace in Brussels, is organised by the European Heart Network and the European Society of Cardiology as part of Work Package 5 of the EuroHeart Project, and speakers include Androulla Vassiliou, EU Commissioner for Health, European Commission, Peter Hollins, President, European Heart Network (EHN) and Francesca Racioppi, Acting Head of the Rome Office, WHO European Centre for Environment and Health.

Still huge inequalities among European countries

While heart disease remains the leading cause of death in Europe, mortality rates are falling in most (but not all) countries, according to new findings released by the EuroHeart mapping project.(1) However, this detailed research, part of a three-year programme to analyse cardiovascular health and prevention policies in 16 European countries, also reveals huge inequalities among countries both in the rate of cardiovascular mortality and in national prevention programmes.

* Highest rates of mortality from coronary heart disease (CHD) in men under 65 were found in Hungary (105 per 100,000 population), Estonia (104), Slovakia (74), Greece (50), Finland (48) and UK (44).
* Highest rates for women under 65 were found in Hungary (28), Estonia (20), Slovakia (19), UK (11), Greece (10) and Belgium (9).
* Lowest rates for men under 65 were found in France (17), Netherlands (22), Italy (25) and Norway (27).
* Lowest rates for women under 65 were found in Iceland (3), France (3), Slovenia (5) and Italy (5).

This pattern was also reflected (though not exactly mirrored) in risk factor prevalence, where, for example, Greece (46%), Estonia (42%), Slovakia (41%), Germany (37%) and Hungary (37%) had the highest rates of cigarette smoking.

There are also noticeable differences in trends in CHD mortality; in Finland mortality rates from CHD declined by 76% from 1972 to 2005; in the same period in Greece, mortality rates for CHD increased by 11%. In nine of the 16 EuroHeart countries, the trends in CHD death rates in women show that they have declined less than in men.

The research also found striking inequalities among the 16 countries in terms of CHD prevention policies and legislation.

* All countries reported some type of legislation covering public health, tobacco control and food. However, Denmark and Greece do not have national policies relating specifically to coronary heart disease.* Belgium, Estonia, Finland, France, Iceland, Italy and Slovenia have five policies in place related to cardiovascular health promotion, CHD, hypertension, stroke and hyperlipidaemia; Greece had just one.* Two countries reported no national guidelines within the broad context of cardiovascular disease (Denmark and Greece). All other countries reported national guidelines on CHD and hypertension, with a minority (Belgium, Finland, Ireland) reporting official government endorsement of existing European guidelines. Most countries had national guidelines on the management of hyperlipidaemia (except Denmark and Greece), diabetes and stroke prevention. Twelve countries (excepting Denmark, Greece and Slovenia) had obesity guidelines.* Only three countries (France, Germany and Ireland) reported recommendations for emergency first-aid (cardio-pulmonary resuscitation (CPR) and access to and training in the use of external defibrillators).