Public patients with heart disease facing ‘extreme waiting times’ in Ireland

Among the serious concerns are figures showing Ireland has the lowest rate of detection of high blood pressure – a risk factor for heart attack and stroke – in western Europe.

The report comes from the National Institute for Prevention and Cardiovascular Health and the National Cardiovascular Disease (CVD) Prevention Council.

It cited "extreme waiting times" for public patients in accessing cardiology services, and a shortfall in follow up services, such as cardiac rehabilitation, for heart attack sufferers.

It is supported by the charity Croí which points out that 80pc of premature cardiovascular disease is preventable.

Some 75pc of people who suffered a heart attack between 2017 and 2020 had no idea in advance they suffered from cardiovascular disease.

“Likewise, more than 1,200 people that suffered an ischaemic stroke in 2020 were found to also have atrial fibrillation (AF), a common type of irregular, usually rapid, heartbeat. However, AF was not identified in 40pc of patients until they suffered the stroke,” the report warned.

Ireland is also without an up-to-date cardiovascular strategy after the last one expired in 2019.

Other deficiencies include problems around the treatment and discharge of patients following the detection of disease.

AF was not identified in 40pc of patients until they suffered the stroke

“These issues include long waiting times in public hospitals and the lack of tailored discharge plans for patients.

“Access to cardiac rehabilitation is paramount to the recovery of those post-cardiac events yet it has significantly declined.

“A 2017 study previously identified that there was national capacity to meet only 39pc of the need for cardiac rehabilitation while in 2021 there was a waiting list of more than 2,800 people, with 40pc waiting at least three months following hospital discharge.

“The issues in the management of patient discharges are particularly worrying when considering that in the absence of Irish data, the report references a Swedish study which reveals that nearly 20pc of people that suffer a heart attack die from a cardiovascular cause or experience a repeat heart attack or stroke within a year.

It calls for the development of a national strategy to tackle cardiovascular disease. It also recommends a screening programme for familial hypercholesterolaemia (FH), a genetic condition which causes dangerously high cholesterol levels from birth.

FH affects around 1 in 200-250 people in Ireland however the majority of this goes undetected. Childhood FH screening programmes are commonplace throughout Europe.

The implementation of electronic health records is identified as a critically important key to integration of services required for effective prevention in clinical practice, said Croí.

Speaking at the launch of the report, NIPC’s research and medical director, Professor Bill McEvoy said: “With Ireland's ageing population, making the prioritisation of CVD prevention part of that transformation is more important than ever,” he said.

“The lack of a national strategy for what is society’s greatest killer is a significant and worrying gap. CVD is a preventable disease, yet it kills nearly 9,000 people per year. We have previously demonstrated national leadership in the space through lasting actions such as the smoking ban; we now need to recognise that more needs to be done to tackle cardiovascular disease.

Dr Angie Brown, medical director of the Irish Heart Foundation, said: “We face a groundswell of rising cardiovascular disease risk factors from population ageing, obesity, and new environmental threats from climate change. These challenges will result in a growing burden of disease and pressure on our healthcare system.”