A programme designed to prevent coronary heart disease in the Republic has saved lives and achieved a significant reduction in risk factors for participants, according to a report published yesterday.
Patients who attended general practice on a quarterly basis over a two-year period achieved a 53 per cent reduction in their total cholesterol levels. There was a 26 per cent reduction in smoking levels, while blood pressure readings improved by up to 45 per cent. It is estimated that 81 deaths have been prevented by the scheme.
Heartwatch, a programme for the secondary prevention of heart disease, has recruited 12,800 patients since March 2003.
The programme covers 20 per cent of general practices in the State where GPs, nurses and other staff provide care to patients according to a standard protocol.
Patients who have had a heart attack or a coronary bypass are invited to participate, and their risk factors for heart disease managed with a view to preventing further cardiac problems. The Heartwatch programme was one of the main recommendations of the 1999 Cardiovascular Strategy - Building Healthier Hearts.
Prof John Feely, chairman of the Heartwatch national screening committee, said: "The results are very clear - there were significant improvements in the management of cardiovascular risk factors such as high cholesterol, high blood pressure and smoking. It is estimated that 81 lives were saved and many future heart attacks and strokes prevented."
The analysis of data on 4,000 of the participants enrolled in Heartwatch for two years found improvements in the prescribing of drugs known to prevent heart disease. Some 90 per cent of patients were receiving statins (cholesterol-lowering drugs), while 87 per cent were taking regular aspirin. And while there were large variations in the prescribing of these drugs between GPs at the beginning of the programme, this variation reduced significantly after two years following the Heartwatch protocol.
However, there was little or no improvement in exercise levels and markers for obesity, such as waist circumference. This has led the authors of the report to suggest the need for more direct intervention to modify lifestyle factors. "The Heartwatch programme has been shown to be both effective and cost effective. It has been shown to increase lives saved and life years gained, and with the cost per life year gained at €7,987 it is a very cost-effective programme."
Welcoming the report, Minister for Health Mary Harney said she hoped it and other chronic disease-management programmes could be extended nationally "in the context of the discussions that are currently taking place" on a new GP contract.