Millions of people suffer from cardiovascular (CV) diseases.1,2 Managing care for these patients can be complex since they have an increased risk of developing related complications and comorbidities such as chronic kidney disease (CKD), heart failure (HF) and other conditions.3,4 Identifying risk factors and intervening early with a focus on lifestyle changes can help prevent cardiovascular diseases.1,5,6
Preventing cardiovascular disease and events while managing risk factors
Without proper risk management and preventative care, the rates of CV disease and related events may continue to rise.1 Many risk factors contribute to this spike including an aging population and other interrelated health issues such as obesity, diabetes, hypertension and dyslipidaemia (high cholesterol).1,5,7,8 Managing these risks early on, however, can help prevent or slow the onset of CV disease and events.9,10
Some risk factors for CV disease and its related conditions such as HF are less well-known, including transthyretin-mediated amyloidosis (ATTR).11 One subtype, transthyretin amyloid cardiomyopathy (ATTR-CM), occurs when a protein called transthyretin (ATTR) misfolds and builds up in the organs, which can cause heart failure.11
Early detection and multidisciplinary care can manage symptoms and comorbidities1,5,6
Other physicians, such as primary care physicians (PCPs), may see at-risk CV disease patients before cardiologists, so education and awareness of CV risk factors is critical. Although prevention is key for these patients and clinicians, an early diagnosis is the next most important step.12
After a diagnosis, coordinated care and communication between different clinicians can lead to safer, and more effective patient care.6,13 Coordination can include communicating and knowledge sharing between clinicians, facilitating care transitions, creating proactive care plans, monitoring follow-ups and connecting patients with the appropriate resources to help them adhere to their treatments and lifestyle changes.6,13 Through coordination, healthcare professionals can help patients receive safer and more effective care to improve outcomes.6,13
Clinicians should also anticipate challenges their patients may face in following their care plans so they can help remove any barriers in the current healthcare environment. Barriers to treatment adherence may include cultural beliefs, lack of access to care, low health education and more.13 If clinicians anticipate these needs, they can work with their patients and identify other resources that can help set a strong foundation to ensure chronic care measures are in place to keep CV disease from progressing.13,14
Cardiovascular disease requires both acute and chronic care approaches
Despite efforts to detect CV disease or identify its risk factors early, some patients can still slip through the cracks and may be treated or even diagnosed in an emergency setting.11 In these situations, patients’ treatment often takes an acute or emergency approach to stabilise patients in the short term before they’re referred to a cardiologist or other clinicians for chronic care.15-17
Improving pathways to care for cardiovascular patients
Preventing CV disease and early detection are lifesaving interventions requiring a lifelong commitment from healthcare professionals across specialties. Coordinating care, educating patients and clinicians, and addressing barriers to diagnosing CV disease can help prevent progression and improve outcomes for the millions affected by these conditions.18
At AstraZeneca, we’re committed to advancing the science to help protect people with CV disease and its related complications and comorbidities. We’re dedicated to increasing awareness and better understanding of CV disease among the complete spectrum of patients to reduce the risk of CV death and hospitalisation.
We continue to invest in the research and development to advance the science and bring forward innovative therapies to address CV patients’ unmet needs and eliminate this disease as a leading cause of death.
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References
1. Cardiovascular Diseases Fact Sheet [Internet]. World Health Organization. World Health Organization; 2021 [cited 2023 Feb 14]. Available from: http://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
2. Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature reviews. Nephrology, 16(4), 223. http://doi.org/10.1038/s41581-019-0244-2
3. Overview - Chronic kidney disease [Internet]. NHS Health A to Z. National Health Service; 2022 [cited 2023Feb14]. Available from: http://www.nhs.uk/conditions/kidney-disease/
4. What causes heart failure? [Internet]. Heart Failure. American Heart Association; 2023 [cited 2023 Feb 14]. Available from: http://www.heart.org/en/health-topics/heart-failure/causes-and-risks-for-heart-failure/causes-of-heart-failure
5. Visseren FL, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, et al. 2021 ESC guidelines on Cardiovascular Disease Prevention in Clinical Practice. European Heart Journal. 2021;42(34):3227–337.
6. Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11).
7. Vaduganathan M, Mensah G, Turco J, et al. The Global Burden of Cardiovascular Diseases and Risk. J Am Coll Cardiol. 2022 Dec, 80 (25) 2361–2371. Available from: http://doi.org/10.1016/j.jacc.2022.11.005
8. About Heart Disease [Internet]. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention; 2022 [cited 2023Feb14]. Available from: http://www.cdc.gov/heartdisease/about.htm
9. Kottke, Thomas E. et al. The Comparative Effectiveness of Heart Disease Prevention and Treatment Strategies American Journal of Preventive Medicine, Volume 36, Issue 1, 82 - 88.e5
10. Rippe, J. M. (2019). Lifestyle Strategies for Risk Factor Reduction, Prevention, and Treatment of Cardiovascular Disease. American Journal of Lifestyle Medicine, 13(2), 204-212. http://doi.org/10.1177/1559827618812395
11. Rintell D, et al. Patient and family experience with transthyretin amyloid cardiomyopathy (ATTR-CM and polyneuropathy (ATTR-PN) amyloidosis: results of two focus groups. Orphanet J Rare Dis. 2021;16:7.v
12. Karunathilake, S. P., & Ganegoda, G. U. (2017). Secondary Prevention of Cardiovascular Diseases and Application of Technology for Early Diagnosis. BioMed Research International, 2018. http://doi.org/10.1155/2018/5767864
13. Care coordination [Internet]. AHRQ. Agency for Health Care Research and Quality; 2019 [cited 2023Feb14]. Available from: http://www.ahrq.gov/ncepcr/care/coordination.html
14. Kalantarzadeh M, Yousefi H, Alavi M, Maghsoudi J. Adherence barriers to treatment of patients with cardiovascular diseases: A qualitative study [Internet]. Iranian journal of nursing and midwifery research. U.S. National Library of Medicine; 2022 [cited 2023Feb14]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580571/
15. Wójcik C, Shapiro MD. Bridging the Gap Between Cardiology and Family Medicine. Circulation. 2019 Aug 27;140(9):709-711. doi: 10.1161/CIRCULATIONAHA.119.040151. Epub 2019 Aug 26. PMID: 31449452; PMCID: PMC6818419.
16. Soto, G.E., Huenefeldt, E.A., Hengst, M.N. et al. Implementation and impact analysis of a transitional care pathway for patients presenting to the emergency department with cardiac-related complaints. BMC Health Serv Res 18, 672 (2018). Available from: http://doi.org/1
17. Zègre-Hemsey, J. K., Garvey, J. L., & Carey, M. G. (2016). Cardiac Monitoring in the Emergency Department. Critical care nursing clinics of North America, 28(3), 331. http://doi.org/10.1016/j.cnc.2016.04.009
18. Geiger I, Reber KC, Darius H, Holzgreve A, Karmann S, Liersch S, et al. Improving care coordination for patients with Cardiac Disease: Study Protocol of the Randomised Controlled New Healthcare Programme (Cardiolotse). Contemporary Clinical Trials. 2021;103:106297.
Veeva ID: Z4-52990
Date of preparation: March 2023