Improving heart disease care
We published five major new SIGN guidelines on coronary heart disease, with the aim of saving more than 7,000 lives over the next five years. Individually, the five guidelines focus on prevention and risk assessment, arrhythmias (irregular heartbeat), acute coronary syndromes, heart failure, and stable angina.
The set of guidelines was accompanied by a detailed report into their resource impact. We also produced, for each guideline, a supporting quick reference guide for healthcare professionals and a version for patients.
Prevention is better than cure
Factors that increase the risk of coronary heart disease include smoking, poor diet, lack of exercise and alcohol consumption. The new guidelines focus on prevention, as well as effective management and treatment of the condition.
The key recommendations on prevention state that everyone over 40 years of age in Scotland should be assessed for risk of coronary heart disease (and stroke) at least once every five years. Lifestyle advice should also be given at these assessments. In addition, we recommend that more people should be considered for statin drugs which reduce cholesterol levels, as well as low‑dose aspirin which helps reduce the risk of blood clots. In total, around 500,000 additional people will receive preventative treatment as a consequence of these guidelines.
Getting the best treatment
On treatment we recommend that patients with the most serious type of heart attack should be admitted to a regional cardiac intervention laboratory for angioplasty (a surgical procedure which removes the blood clot and implants a piece of mesh to keep the artery open). If this is not possible within 90 minutes of diagnosis, the patient should rapidly receive the most effective clot-busting drugs. We also recommend that more patients with arrhythmias and heart failure should receive specialist implants and therapy to correct the irregular heartbeat and to reduce the risk of sudden death. Moreover, we recommend that discharge arrangements for patients hospitalised with heart failure should be improved. The guidelines are also about NHS boards formulating a vision, setting out the long‑term goals for the improvement of coronary heart disease services in Scotland. Their implementation will require careful planning and management of resources.
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