Initial results from the largest ever national programme to target heart disease in the community have shown a significant improvement in blood pressure and cholesterol levels among participants.
Heartwatch, the national general practice programme for the secondary prevention of cardiovascular disease, which has enrolled 10,000 patients since it commenced in February 2003, published an initial evaluation of its activities at the Irish College of General Practitioners (ICGP) a.g.m. in Galway yesterday.
The patients had all suffered a previous cardiac event such as a heart attack. Their recruitment to Heartwatch is designed to prevent further heart problems by intervening in risk factors for heart disease such as high blood pressure, cholesterol and smoking. The results show that even after three months in the programme, the percentage of patients with normal blood pressure rose by eight points, from 55 per cent to 63 per cent.
Those with normal cholesterol levels rose from 65 per cent to 75 per cent after nine months. Even risk factors which require a longer period of intervention before an improvement is seen, such as smoking and exercise, showed modest levels of improvement.
Some 76 per cent of patients were using a cholesterol-lowering drug. Combined with the cholesterol results, this suggests that while most are on appropriate medication, some patients may not be on a sufficient dose. The use of aspirin and antiplatelet medication, recommended under European guidelines, was good by comparison with other EU states.
In what is the largest health intervention project ever undertaken in the Republic, Heartwatch recruited 20 per cent of GPs here into the programme. Some 470 GPs and their practice nurses in 325 practices from all 10 health boards in the State participated.
GP co-ordinators and nurse facilitators were recruited in each health board and an independent national data centre (INDC) was specifically set up to manage the flow of information from medical practices.
The programme, which cost €3 million to run, is a partnership between the Department of Health, the health boards, the ICGP and the Irish Heart Foundation. It was first proposed in the 1999 National Cardiovascular Strategy, Building Better Hearts, which stated that the secondary prevention of heart disease should be carried out, for the most part, in primary care.
The next phase of the project will involve the recruitment of a further 470 general practitioners as well as enlarging the programme to include the primary prevention of cardiovascular disease.
Commenting on its progress to date, Dr Séan McGuire, Heartwatch's national programme director, said: "The programme is proving to be an outstanding success. Even at this early stage it is showing benefits for a group of patients with established coronary heart disease and should ensure a reduction in morbidity and mortality in the longer term." Is was essential the programme be expanded to include a greater percentage of patients, he added.
Heartwatch's national programme manager, Mr John Leahy, pointed to the information technology benefits of the project.
"As the first programme dependant on primary care, it has meant a huge change within general practice," he said, adding that the creation of the INDC means the infrastructure is in place for it to be used in other areas of healthcare.
It is expected that the Heartwatch programme will be formally launched by the Minister for Health, Mr Martin, in the coming months.