Cardiovascular pathologies associated with age occupy an increasingly central place in the debate on active aging and the quality of life of the elderly, as explained in the virtual debate «Active and healthy aging: the role of the heart»organized by CEOMA.
This forum has brought together political representatives and health experts to discuss the importance of cardiovascular health in the functional deterioration of the elderlyfrom the perspective that adequate knowledge is essential to respond to the challenges posed by an increasingly aging society.
To this we must add that COVID-19 has had a direct impact on the protocols for action and treatment of pathologies such as structural heart disease, giving rise to new approaches and needs. The structural heart diseaseclosely linked to aging, appears with the failure of the heart valves due to longevity, causing pathologies such as aortic stenosisthe mitral regurgitationeither tricuspid, among other. The interruption of the diagnosis and treatment of these pathologies generates great concern among health professionals, by increasing the vulnerability of the elderly to future waves of coronavirus like the one we are already experiencing.
The health of older people with cardiovascular disease has deteriorated due to interruptions in diagnosis and treatment
The President of , Juan Manuel Martinez Gomezstressed that “It is essential to take into account the role of the heart in enabling active and healthy aging to increase the quality of life of the elderly”given that “Cardiovascular diseases are the most frequent cause of death among these people”. In this sense, rosemary rosePresident of the Health Commission of the Congress of Deputies, pointed out that it is the responsibility of the public powers to seek urgent solutions to this problem, indicating that “the pandemic has generated a double vulnerability of the elderly since the severity of these pathologies has increased”. According to Rosemary, “Active aging must be a right, even in times of pandemic. The efficient approach to cardiac pathologies will allow us to ensure social and health sustainability”.
Cardiovascular health must be a priority
In her speech, Dr. Clara BonanadPresident of the Geriatric Cardiology Section of the Spanish Society of Cardiology (), exposed the most relevant cardiac pathologies associated with aging and analyzed the impact of COVID-19 on patient management. In Bonanad’s words, “We are facing a true epidemic” against cardiac pathologies associated with advanced age.
In this regard, the President of the Spanish Society of Cardiovascular and Endovascular Surgery (), Fernando Hornerohighlighted the seriousness of the problem, “there is a lack of equity between Autonomous Communities in the response to these pathologies”. In addition, although the medical response to heart disease is getting better and better, thanks to technological advances that make it possible to diagnose and treat older patients, it is still “he 20 percent of the population is expected to die as a result of heart problems”.
The valve disease they can become major health problems and direct barriers to active aging, according to the President of the Association of Carriers of Cardiac Valves and Anticoagulants (), Cecilia Salvadoremphasizing that these pathologies associated with age cause dependency, continuous hospitalizations and high mortality that could be avoided “starting from a better diagnosis, with the stethoscope use in medical visits. And it is that Spain is behind other neighboring countries in the use of this tool in routine check-ups, which allows many patients to be detected on time. “We have very low rates of diagnosis, we must increase the knowledge of the population”, warns this expert.
In view of the clinical severity of these pathologies, geriatricians Jose Augusto Garcia NavarroPresident of the Spanish Society of Geriatrics and Gerontology (), and Jose Manuel Ribera Marriedhimself a cardiologist and promoter of the Geriatric Cardiology Section of the SEC, agreed that there is an obligation to establish the early detection of these pathologies and guarantee rapid treatment prevent functional decline. “Cardiovascular disease by itself is capable of increasing physical dependence, in addition to causing depression and cognitive impairment,” pointed out the President of the SEGG, noting that “One in three patients worsens their physical capacity in a striking way”. For his part, Jose Manuel Ribera recalled the need for fight age discriminationand to pay particular attention to the causes of functional deterioration such as heart disease.
The current coronavirus pandemic continues to worsen cardiovascular health among the elderly, given the health collapse experienced especially in March and April of this year. For riverbank“age discrimination has been accentuated with COVID, in access to emergency services and health care”.
“In the first wave of coronavirus, older patients with cardiovascular disease were affected, and primary care was reduced by 40%,” according to the cardiologist Bonanad. “The fear of going to the hospital is accompanied by a worsening of the underdiagnosis”.
As reflected in data from the Society of Cardiovascular and Endovascular Surgery, the pandemic has put a significant brake on the healthcare approach to cardiovascular pathologies. Surgical activity was paralyzed, “with special affection in Catalonia, Madrid and Andalusia”, he concluded baker, with the high deterioration in the care of the elderly that this entails. In order to avoid these disruptions in future waves, Dr. Clara Bonanad recalled the recent recommendations of the Association of Interventional Cardiology, which indicate the need to prioritize these pathologies through minimally invasive treatments that reduce the use of critical hospital resources such as ICUs and hospital stay, to allow continuity of care in these times of high pressure on the healthcare system.
Faced with this situation, patient representatives ask to return to hospitals and health centers in the best possible conditions. “From AEPOVAC we have made an appeal for patients to continue going to health centers with symptoms of cardiovascular diseases” despite the current restrictions, according to the president of patients with valve disease, Cecilia Salvador.
Efficient approach to structural heart disease
Another of the issues addressed in this debate was the need for an efficient approach to structural heart disease. The speakers agreed to make a call to raise awareness among the population about the importance of cardiovascular health to promote active agingas well as for the health administrations prioritize effective approach to increase the efficient use of health resources in health reconstruction.
In fact, the Ministry of Health finalizes and new Strategy in Cardiovascular Healthwhich, according to its Technical Coordinator, Sonia Pelaez, “intends to improve the quality of life by reducing the incidence, mortality and morbidity”. The Strategy, which is based on four backbones, includes valvulopathies for the first timewhich “They have been included on this occasion due to their higher prevalence with age and the burden they entail”advocating for a “early diagnosis and effective treatment”. Once approved in the coming months, it will be the turn of the Autonomous Communities to implement programs and action plans through social and health reconstruction policies that develop this response in a context that is still a pandemic.
For the parliamentary spokespersons of the PP and PSOE, as expressed in the final debate, the situation goes through increase diagnosis and improve efficiency in healthcare. The health spokesperson of the PP in Congress, Elvira Velascorecalled that many advances have been made since the ischemic heart disease plan, but “There is still much left to do”, stressing that “It is unknown if the new Cardiovascular Health Strategy will be accompanied by financing” I don’t even know “It will encourage citizen participation in health”. Given the disruptions experienced during the pandemic, “We hope that in this second wave the same thing will not happen again, and that measures will be put in place to allow the continuity of diagnosis and treatment of these pathologies”said the popular spokesperson.
For her part, the health spokesperson of the PSOE in the Senate, Esther Carmonaexpressed his group’s concern about the especially severe structural heart diseaseas it is considered one of the causes most closely linked to the functional decline in the elderly. In order to solve all the problems raised, the socialist senator announced the recent registration of a motion for debate in the Senate, urging the Government to deal with the functional deterioration of the elderly through the efficient approach to structural heart diseases.