They suggested that prevention of ill health should include not only anti-smoking messages and reducing high blood pressure, but also encouraging weight loss and exercise.
This comes after research showed that an overall decline in the number of people with coronary heart disease over the past 20 years has been offset by an increase in other heart conditions, such as valve disease and blood clots.
The study, published in the BMJ, included 1.65 million people registered with a general practitioner who had at least one new diagnosis of cardiovascular disease between 2000 and 2019.
The researchers evaluated trends in 10 venous thromboembolism conditions, including stroke, heart failure, atrial fibrillation and flutter, heart block, aortic aneurysm, acute coronary syndrome, aortic stenosis, chronic ischemic heart disease, peripheral arterial disease, deep vein thrombosis and pulmonary embolism.
The study found that between 2000 and 2019, the incidence of the 10 diseases fell by about 19%, while the incidence of coronary artery disease and stroke fell by 30%.
Further analysis revealed that the decline in coronary heart disease was mainly seen in patients over 60 years of age, while the decline in younger people had “stagnated.”
The researchers said the trend has been seen in other high-income countries and suggested it may be due to rising rates of obesity, physical inactivity and type 2 diabetes among young adults.
“The halting of decline suggests that preventive measures may need to be expanded beyond smoking cessation, blood pressure control, and lipid-lowering interventions to include promoting physical activity, weight management, and the use of newer therapies shown to reduce cardiovascular risk in patients with type 2 diabetes,” the researchers added.
![General practitioner taking a patient's blood pressure](https://image.assets.pressassociation.io/v2/image/production/c2f0c6f3786f7df84a7a70eed672ed60Y29udGVudHNlYXJjaGFwaSwxNzE5NDgzMTcy/2.76188359.jpg?w=640)
The researchers said that while rates of heart disease in people under 60 are “generally low”, identifying those at risk at a younger age and intervening before problems begin could reduce premature deaths and have “an important economic impact”.
The study also noted that there was an “increased diagnosis of arrhythmias, valvular disease, and thromboembolism.”
The researchers said they observed a “socioeconomic gradient” in “almost every” medical condition they studied.
Rates were higher in the north of England, where rates of aortic aneurysm and aortic stenosis were around 30% higher than in London.
The study was funded by the Flanders Research Foundation, the European Society of Cardiology and the British Heart Foundation (BHF).
Dr Sonia Babu Narayan, BHF deputy medical director and cardiologist, said: “We know that by 2019 decades of progress in saving the lives of heart patients had stalled, and now, with the pandemic, it’s only going to get worse.”
“This study makes clear that to once again accelerate progress in reducing the impact of cardiovascular disease, we need to address the different types of cardiovascular disease.
“The link between heart health and wealth is well established. With cardiovascular disease claiming one in four lives in the UK, it is vital that prevention, early diagnosis, treatment and care reach those who need it, when they need it, wherever they live.”
“And by revitalizing cardiovascular science with adequate funding, we can continue to produce breakthroughs that help more people live longer, healthier lives.”