A study conducted by researchers at the University of Leeds has discovered that, even though hospital death rates for heart attack patients across all age groups have been reduced considerably, there are still concerns regarding the inequalities in heart attack management for elderly individuals. The study was funded by the British Heart Foundation (BHF) and published in the European Heart Journal.

The research revealed that between 2003 and 2010 the risk of heart patients across all age groups dying in hospital was reduced by almost fifty percent. Although specialist treatments, such as coronary angioplasty – a procedure used to improve blood flow to the heart by opening up blocked or narrowed arteries – are more widely available to heart attack patients, individuals over the age of 85 are less likely than patients in other age groups to receive specialist care from a cardiologist and crucial medicines when discharged from hospital.

They discovered that individuals who are over 85 years are 75% less likely than patients under the age of 55 to receive emergency percutaneous coronary intervention (PCI) or thrombolysis. These treatments are designed to restore blood to parts of the heart starved by oxygen. In addition, they also found that those over 85 were significantly less likely to receive important heart medications, such as statins and beta blockers after treatment.

The improvements in specialist care are proof that the National Service Framework for Coronary Heart Disease (NSF CHD), a Department of Health strategy to improve CDH services over the past decade, has made an impact. The plan has been vital in giving health services a focus to reduce deaths and disabilities in England and Wales. Although, results from this strategy have also underlined that different age groups have unequal access to heart care.

The investigators used data drawn from over 600,000 heart attack events that were documented in the Myocardial Ischemia National Audit Project (MINAP), which analyzed the quality of management of heart attacks in 255 hospitals throughout England and Wales.

Dr Chris Gale, NIHR Clinician Scientist at the University of Leeds and Consultant Cardiologist, who led the study, explained:

“The NSF has led the NHS to make great strides in heart attack treatment by ensuring the best proven treatments are available to heart patients across England and Wales.

But as the results for the elderly show, despite dramatic improvements in their care, we shouldn’t be complacent. There’s still progress to be made, not just in-hospital but after patients are discharged and a GP is then responsible for their care.”

Natasha Stewart, Senior Cardiac Nurse at the BHF, stated:

“This study highlights the importance of providing the best possible care to all heart patients regardless of their age. It’s not fully clear why the over 85s are missing out but it’s wholly unacceptable that elderly heart attack patients do not have equal access to a cardiologist in the UK. This reduces their chance of getting early interventions, even though there’s evidence that they would benefit just as much as younger patients.

The NSF has clearly helped to improve and standardize treatment and care for heart attack patients. But the continued inequalities demonstrated in this study – combined with the fact that coronary heart disease is still the UK’s single biggest killer – emphasizes the need for a renewed approach to address the huge future challenges we face.”

Written by Grace Rattue