New battle against killer condition

CORONARY heart disease is one of the biggest killers of Ipswich residents, aside from cancer.Tackling the disease has become a priority both for the Government and Ipswich PCT.

By Jessica Nicholls

CORONARY heart disease is one of the biggest killers of Ipswich residents, aside from cancer.

Tackling the disease has become a priority both for the Government and Ipswich PCT.

A study by Dr Brian Keeble, Director of Public Health, has revealed that while death rates in the region have dropped in the last eight years, in 2002 Ipswich Primary Care Trust had the highest death rate out of all Suffolk's PCTs.


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And people living in deprived areas are more likely to fall victim to the disease. However people over the age of 75 are less likely to be given the procedures that can enhance their quality of life.

Dr Keeble added that in the early years of the 21st century falling death rates now seem to have ground to a halt and more needs to be done to encourage lifestyle changes.

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His study also revealed evidence that the further away a patient lives from heart specialist hospital, Papworth, the less likely they are to receive assessment and treatment for heart conditions such as angina (furred up arteries blocking blood flow to the heart).

Dr Keeble said: "That is one of the things that surprised me most.

"Particularly in the first half of the study the difference was quite strong.

"It is quite a common phenomenon with tertiary units like Papworth for quite a number of reasons.

"For example with those who live nearer the centre the GP might know the people who work there and might be more willing to refer their patients there and once referred they might be more likely to get treated and so on.

"GPs further away might not know what services are available. Patients also might be more reluctant to go because they might have to travel further.

"There is a variety of reasons."

However in the second half of the eight-year study from 1999 to 2002, referrals from Ipswich Hospital rose by 20 per cent.

Later this year a special centre to carry out assessments and treatments such as angiography and revascularisation is also set to open at Ipswich, which should mean more patients get the chance to have the procedure.

An angiography is when doctors pump dye into the artery of the patient who has had a heart attack or angina so doctors can see where the blockage is.

Revascularisation is the procedure, which helps to open up the blockage. It is not a cure for the condition but can improve quality of life.

The study which ran from April 1995 to 2003 also found that Ipswich stands second highest in the county for heart attack rates.

In his report Dr Keeble said: "In people under the age of 75 there was a strong and significant association between the occurrence of heart attack and the levels of deprivation at the local authority ward level, with more deprived wards having higher heart attack rates.

"Somewhat worryingly the occurrence of heart attack in the most deprived wards in Ipswich did not decline over the period of this study as it did elsewhere in the PCT area.

"The PCT needs to keep an eye on this and be prepared to adopt a more proactive, systematic and evidence based approach to CHD and its consequences if this trend persists."

And while the amount of angiography and revascularisation taking place is on the increase in the town, it is falling way behind other areas in the county.

Figures showed that out of the 41 wards in Suffolk, Ipswich was 33rd on the list for the amount of angiographies given between 1999 and 2002 and 29th on the list for revascularisation in the same period.

Dr Keeble's also revealed that people over the age of 75 in Ipswich seem to get less access to the procedures.

He said that the situation needed to be monitored by the PCT and Ipswich Hospital to find out why it was happening.

Dr Keeble said: "Over 75s account for 38 per cent of presentations with heart attack at hospital but only 12 per cent of angiographies.

"Is it discrimination? It cannot be answered from a survey but it raise a number of questions that we need to be asking our hospital colleagues."

Dr Don McElhinney, vice chairman of Ipswich PCT trust said it would be taken to the joint control governance committee at the hospital to see why there were these differences, but it was pointed out that not everyone who has a heart attack is found to need an angiography so this could be part of the reason.

He added: "The new General Medical Services (GMS) contract is centred around this.

"We want to get people at the early stages (of the disease). People with suspected angina will get seen within two weeks at the chest pain clinic in the hospital.

"We can identify whether they have angina or not so that people can start to alter their lifestyles in the early stages."

Although there was a decline in the heart attack rate, Dr Keeble found that more people are going to hospital with them, which he said is a good sign.

He said: "We have the highest rates in the county for people presenting at hospital.

"That is a good sign because we know that with the care people get in hospital their chances of survival are increased.

"Heart attack presentations at hospital are also becoming more common from the deprived wards – this could be because heart attacks are increasing, more people are going to hospital or that we have more sophisticated instruments to pick up heart attacks."

WHAT CAUSES HEART DISEASE?

Five steps to a healthy heart:

Healthy eating – cut back on red meat, biscuits, cakes, chips and dairy products which can clog up your arteries and put a strain on your heart. Eating fish, poultry and vegetables can help.

Be more active – Include half an hour a day of exercise into your daily routine. Start off gently and build it up gradually.

Stop smoking- the risk of heart attack reduces from the moment you stop and is halved one year after giving up.

Reduce alcohol – Binge drinking will increase your risk of having a heart attack.

Trim excess weight – Eating a balanced diet, drinking alcohol in moderation and increasing levels of activity maintains a healthy body and heart.

Information source – British Heart Foundation – www.bhf.org.uk

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