Cardiovascular Disease Prevention in Clinical Practice – The National Coordinator Dr Siobhan Jennings, Dr Siobhan Jennings, Consultant in Public Health Consultant in Public Health Medicine Medicine National Coordinator National Coordinator Irish Cardiac Society Irish Cardiac Society
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Cardiovascular Disease Prevention in Clinical Practice – The National Coordinator Dr Siobhan Jennings, Consultant in Public Health Medicine National Coordinator.
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Cardiovascular Disease Prevention in Clinical Practice –
The National Coordinator
Dr Siobhan Jennings, Dr Siobhan Jennings, Consultant in Public Health MedicineConsultant in Public Health Medicine
National Coordinator National Coordinator Irish Cardiac SocietyIrish Cardiac Society
Age Standardised Mortality Rates per 100,000 population, 0-64 years
0
20
40
60
80
100
120
140
160
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
Year
Ag
e S
tan
dar
dis
ed M
ort
alit
y R
ate Ireland - Diseases of the
circulatory system
EU15 - Diseases of the circulatorysystem
Ireland - Ischaemic heart disease
EU15 - Ischaemic heart disease
Ireland - Cerebrovasculardiseases
EU15 - Cerebrovascular diseases
Source: WHO-HFA-DB
-4000
-3000
-2000
-1000
0
37633763fewer deathsfewer deaths
Risk Factors worse +14%Risk Factors worse +14%
Risk Factors better Risk Factors better ––61%61%
Treatments Treatments -- 43.6%43.6%
2000200019851985
CHD mortality fall in Ireland 1985 CHD mortality fall in Ireland 1985 -- 2000 explained by 2000 explained by a) treatments in CHD patients & b) population risk factora) treatments in CHD patients & b) population risk factorss
Ford, E. S. et al. J Am Coll Cardiol 2007;50:2128-2132
CHD TRENDS: US ( x age groups)Trends in Age-Specific Mortality Rates From Coronary Heart Disease
SLÁN 2007 Hypertension Profile,SLÁN 2007 Hypertension Profile, n=1,207 age 45+ n=1,207 age 45+
CVD Medication Use - GMS Scheme CVD Medication Use - GMS Scheme (1998-2006)(1998-2006)
Prescribing frequency of CVD drugs in Ireland under the
GMS scheme 1998-2006
0
500
1000
1500
2000
2500
1998 1999 2000 2001 2002 2003 2004 2005 2006
1000
pre
scrip
tions
Aspirin (Anti-thromb) Diuretics BB ACE i CCB LLD
CVD PreventionCVD Prevention
• Population approachPopulation approach
• Secondary preventionSecondary prevention
• High risk approachHigh risk approach– 4JTF from ESC adopted by CVD Policy, 20104JTF from ESC adopted by CVD Policy, 2010– Record risk factors, Assess risk, consider Record risk factors, Assess risk, consider
intervention intervention
ESC brief for National Co-ordinator
• FacilitateFacilitate ……….. endorsement, adaptation, and publication of guidelines
• Co-ordinate Co-ordinate ……….adaptation and dissemination of CVD Preventions tools
• Build national alliancesBuild national alliances (multidisciplinary, professional)
• Make contact withMake contact with Health Health (and Local) Authorities promoting EHHC
• Act asAct as direct contact persondirect contact person with ESC Co-ordinator
National Coordinator – my approach
• Asked by Irish Cardiac Society
• Discussions with IHF (and within HSE) – Review of Councils - Council on
• Prof Ian Graham (Chair)• Dr Siobhan Jennings (National Coordinator, ROI)
• Dr Mahan Varma (National Coordinator, NI) • Prof H Mc Gee• Dr Joseph Harbison• Dr Angie Brown• Dr John Cox• Dr Pat Doorley• Prof Eoin O Brien• Dr John Devlin• Mr Michael O Shea• Ms Bridget Caffrey- Armstrong (Project Manager)
National Coordinator – my approach
• Asked by Irish Cardiac Society
• Discussions with IHF (and within HSE) – Review of Councils - Council on