Can we stop the heart disease epidemic?

Abstract

Cardiovascular disease is responsible for around 46% of deaths in Malta, of which more than half are due to coronary artery disease (CAD). What is, however, more important is that CAD is the number one cause for potential years of life lost in those under the age of 65 years with 12.8% of all deaths. CAD secondary to atherosclerosis is viewed as a disease of developed countries and the characteristic western diets, and is associated with obesity, smoking and lack of exercise. It is also more common in countries having an ageing population, which in itself is a sign of prosperity and associated good healthcare. Notwithstanding these facts, in recent times, we have started experiencing improving rates of age-adjusted cardiovascular mortality in the western world. This is primarily attributed to increased awareness of risk factor modifications for primary prevention, as well as medical advances in treatment. The latter, however, is expensive and less cost effective than primary prevention. In parallel, we are also witnessing an increase in incidence of cardiovascular morbidity and mortality of epidemic proportions in Eastern Europe and the developing countries. From an economic point of view, with the current global economic situation, especially in developing nations, the burden of treatment of cardiovascular disease can overwhelm the already stretched healthcare services.