Plan ‘could cut heart attack deaths by 80%’

DEATHS from heart attacks or strokes could be reduced by 80% if high-risk patients were identified and treated early, a study has found.

An interim report on the Reduction of Heart Attack Through Prevention (RHASP) programme predicts its extension to 20,000 high-risk patients over a 10-year period would prevent more than 1,000 heart attacks and 500 strokes.

It also claims the programme, which includes the sharing of a common database between GPs and the Blood Pressure Unit at Beaumont Hospital, could be made available to all surgeries for less than €10,000. The 12-month pilot study, involving six general practices in north Dublin, recommends the greater use of drugs to reduce blood pressure and cholesterol levels.

Its authors claim the RHASP target of halving stroke and heart attack among high-risk patients through improved targeting is “realistic and achievable”.

Professor Eoin O’Brien, a consultant cardiologist at Beaumont Hospital and coordinator of the RHASP project, said one of the primary reasons for Ireland’s high incidence of cardiovascular disease is poor targeting of high-risk patients and the absence of data to identify them.

He said past efforts had shown drug prescription was more effective than lifestyle change in reducing heart disease rates.

At the outset of the RHASP study, only 17% of patients were on appropriate medicine, compared to 66% after just six months, said Professor O’Brien. They included a combination of statins, aspirin and beta-blockers.

Prof O’Brien said the principal effect of the RHASP project was the prevention of the premature ageing of patients’ cardiovascular system.

He highlighted the importance of rolling out such a programme on a national basis. “We don’t need more data on drugs. We need vision that recognises the need to implement evidence-based knowledge.”

He encouraged doctors to recognise the benefits which medicines provide in prevention and treatment. “In essence, that means more aggressive drug treatment.”

The pilot project, in the Eastern Regional Health Authority, was undertaken because we have one of the highest incidence and mortality rates in Europe for heart attacks and strokes. In 2001, 41% of all deaths here were due to cardiovascular disease.