European Heart Valve Disease Awareness Day 2018: New Data Indicates Low Awareness of Heart Valve Disease May Prevent Elderly People from Seeking Diagnosis and Treatment
· The call for improved education and diagnosis of heart valve disease comes following the results of a new survey of 12,820 people over the age of 60 in 11 European countries
- Only 3.8% of people know what aortic stenosis is, one of the most common forms of heart valve disease, despite it affecting approximately 2.7 million over 65s in Europe[i],[ii]
- Levels of concern for heart valve disease are very low (2.1%) compared to cancer (28.8%) even though annual mortality of severe aortic stenosis is higher than most cancers1,[iii],[iv]
- Only 46% of people regularly had their heart checked with a stethoscope which is the first step to detecting the condition, with only 24.06% of women having their heart checked at every visit compared to (30.2%) of males1
LONDON – 6th September 2018 – A new survey of 12,820 over 60s across Europe indicates that low levels of awareness of heart valve disease may prevent elderly people from seeking diagnosis and treatment.1 The results from the survey, published in Clinical Research in Cardiology, coincide with the first ever European Heart Valve Disease Awareness Day taking place in six countries on 8 September 2018. The campaign calls for action to improve awareness, early diagnosis and treatment across Europe.
The findings, which consider the results alongside those of an awareness survey conducted two years ago, indicate more people are familiar with heart valve disease in general yet, alarmingly, understanding of aortic stenosis, one of the most common forms of heart valve disease affecting between 2-7% of people over the age of 65 has decreased.[v] Only 3.8% of survey respondents could correctly identify this form of heart valve disease compared to 7.21% in 2015.1 In addition, almost two fifths of respondents (38.10%) were unaware of treatment options for heart valve disease.1 This is despite the fact that approximately 2.7 million people over 65 years of age are thought to suffer from aortic stenosis in Europe, a number only set to increase due to Europe’s ageing population.2
As levels of understanding remain low, so too do levels of concern for heart valve disease among Europeans. Despite a slight increase over the last two years (2015:1.7% vs 2017:2.1%), levels of concern are particularly low when compared to cancer (28.8%) or Alzheimer´s disease (20.9%).1 This is despite annual mortality of severe aortic stenosis being considerably higher than most cancers.3,4 This lack of understanding and concern for heart valve disease may prevent elderly people from seeking diagnosis and treatment.
“Results from this awareness study shows superficial knowledge of heart valve disease has increased but surprisingly people are still not sufficiently informed about heart valve disease and therefore show little concern for the condition,” Professor Helge Möllmann, lead author and Cardiologist, St.-Johannes-Hospital, Dortmund, Germany comments. “Treating heart valve disease can return people to a good quality of life and normal life expectancy, so it is extremely important to educate and inform people on the condition.”
Heart valve disease is a common, but treatable, heart condition where the heart valves no longer work properly. When the valves are diseased it can rapidly affect the pumping action of blood around the body. Symptoms of heart valve disease include chest pain, fatigue, shortness of breath, difficulty exercising and fainting and it can lead to sudden death.[vi] However, many patients do not suffer severe or visible symptoms, or put their symptoms down to the natural ageing process, making diagnosis difficult.6 It is important to diagnose early as, if severe aortic stenosis is left untreated, half of those patients will die within two years of developing symptoms.[vii]
The survey revealed that respondents are most likely to report chest pain followed by chest tightness but nearly a fifth of respondents (19.8%) were unlikely to mention shortness of breath to their GP despite it being a common symptom of heart valve disease.1
Results indicate there continues to be discrepancy between the regularity with which men and women have stethoscope checks, with only 24.06% of women having their heart checked at every visit compared to (30.2%) of males.1 This puts women at higher risk of receiving a late diagnosis as using a stethoscope to listen for a characteristic heart ‘murmur’ is the first step to identifying a problem with the heart valves.[viii]
Additionally, the survey found that stethoscope use, although improved in recent years, remains infrequent. Fewer people now rarely or never undergo auscultation (2015: 54.2% vs. 2017: 50.6%, p<0.001) and more Europeans currently have their hearts listened to by a doctor at every visit than two years previously (2015:24.2% vs. 2017:27.2%; p<0.001) However, the majority (54.1%) of people aged 60 or older are still not checked regularly.1
“The population itself must be aware of heart valve disease in order to initiate the first step in effective diagnosis – noticing symptoms,” commented Professor Helge Möllmann. “The 8th September 2018, is a monumental day as it marks the first ever European Heart Valve Disease Awareness Day, a day focused on four key aspects to improve diagnosis and access to treatment across Europe. The results of this survey clearly show importance of having a day dedicated to improving understanding of heart valve disease and also highlight the urgent need for doctors to keep using their stethoscope, which is the key to diagnosis.”
Encouragingly, although there is relatively low awareness and understanding of heart valve disease and potential treatment options, after receiving more information about the condition, survey respondents cited heart valve disease as a condition they wish to be checked for. Blood pressure was the condition most respondents wanted to be checked for regularly by GPs, with heart valve disease coming in a close second.1
There is an urgent need for improved awareness of heart valve disease and its effective treatments amongst patients and doctors in order to ensure a fully informed population who understand their symptoms and report them to their doctor. The primary treatment is heart valve replacement, either via open-heart surgery or a minimally invasive procedure such as a Transcatheter Aortic Valve Implantation (TAVI). Treatment can alleviate symptoms, prolong a patient’s life span and improve health and quality of life.[ix]
Using a stethoscope to listen to the heart is one of the simplest steps that doctors can take towards diagnosis. Implementing regular heart health checks for heart valve disease after the age of 65 would increase regular stethoscope checks, thereby supporting early diagnosis of heart valve disease, which is key to improving outcomes.