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Advancing a prevention agenda for cardiovascular care in Ireland

HPP was invited by leading stakeholders to develop a position paper advocating for a new national strategy for cardiovascular health in Ireland.

Advancing a prevention agenda for cardiovascular care in Ireland

Context

Ireland lacks a national plan for cardiovascular disease (CVD), which is a leading cause of death and major acute events. Yet most cases of CVD, and many of the hospital admissions and deaths it causes, are avoidable.

Each year, nearly 9,000 people in Ireland lose their lives to CVD, yet an estimated 80% of premature heart attacks and strokes are preventable. Although mortality rates from CVD in Ireland have declined over time, they are projected to rise again as a result of Ireland’s ageing population and the higher risk associated with increasingly prevalent conditions such as diabetes and obesity.

A greater focus on prevention across the whole spectrum of CVD is needed to save thousands of lives each year and ease the pressure on Ireland’s healthcare system.

Ireland has already made great strides in improving the health of its population and investing in CVD prevention. For example, the country has long been viewed as a world leader in smoking cessation, which is an important population-level CVD prevention strategy. Within the healthcare system, recent developments – including the implementation of national clinical programmes for stroke and heart disease – and their linkage to wider health system improvement programmes have demonstrated a policy-level commitment to addressing the burden of CVD.

Although national CVD strategies were in place from 1999 to 2019, the most recent strategy has now lapsed, has not been formally evaluated and has yet to be replaced.

Structural challenges remain across the entire healthcare system, particularly in delivering more intensive and person-centred care and support to those living with chronic (elevated) CVD risks and long-term cardiovascular conditions. A renewed political commitment to addressing CVD, with a clear focus on prevention at all levels, is therefore urgently needed. Equally, greater prioritisation of prevention – from early detection of risk factors to preventive services for people who have been hospitalised with CVD – must be brought to the fore, as current clinical improvement programmes may not fully address the known gaps in this area.

Project resources

Advancing a prevention agenda for cardiovascular care in Ireland

Position paper

Advancing a prevention agenda for cardiovascular care in Ireland: position paper

What we’ve achieved

To address this situation, HPP supported leading organisations in calling for a new national strategy built around the prevention mindset to reduce the burden on individuals and society at all stages of cardiovascular disease. We united leading Irish CVD stakeholders on an original, action-orientated consensus for prevention at all stages of cardiovascular disease.

We researched and wrote a position paper, which was launched with direct ministerial involvement in Dublin in February 2023. Despite the preventive approach being relatively untested among the global CVD community, the position paper provides a powerful and comprehensive vision for change aimed at policymakers and health system leaders. We hope this approach will inspire CVD stakeholders across Europe and the world to present similar visions for change to decision-makers in other countries.

Through extensive desk research, expert interviews and consultation with the project steering committee, we identified five components of effective prevention in CVD, along with four key system-wide changes needed to enable progress in CVD prevention. The position paper presents each of these elements in turn, analysing the current situation in Ireland and providing specific recommendations for improvement. It also includes five case studies, which serve as examples of best practice and may be helpful when developing new policies and programmes.

Key partners and stakeholders

This project was developed with the support of the following partners and stakeholders:

Project leaders:

  • Neil Johnson, CEO, Croí West of Ireland Cardiac and Stroke Foundation and National Institute for Prevention and Cardiovascular Health
  • Julia O’Connor, Former Director of Operations and Development, National Institute for Prevention and Cardiovascular Health

Steering committee members:

  • Dr Angie Brown, Medical Director, Irish Heart Foundation; Consultant Cardiologist, Dublin
  • Professor J. William McEvoy, Research and Medical Director, NIPC; Professor of Preventive Cardiology, University of Galway
  • Norma Caples, Former President, Irish Nurses Cardiovascular Association
  • Dr Joe Gallagher, Integrated Care Lead for Cardiovascular Disease, Irish College of General Practitioners and Health Service Executive
  • Professor Vincent Maher, Former President, Irish Cardiac Society
  • Dr Ambrose McLoughlin, Chair, HeartBeat Trust
  • Darragh O’Loughlin, Pharmacist; Former President and Secretary General, Irish Pharmacy Union
  • Professor Emer Shelley, Chair, Irish Heart Foundation

Interviewees:

  • Professor Paddy Gillespie, Head of Economics and Director of Health Economics & Policy Analysis Centre, University of Galway
  • Professor Ian Graham, Professor of Cardiovascular Medicine, Trinity College Dublin; Chair, National CVD Prevention Council
  • Professor Patricia Kearney, Professor of Epidemiology, School of Public Health, University College Cork
  • Dr David McConaghy, Prevention Lead, Irish College of General Practitioners
  • Dr Patricia O’Connor, Consultant in Internal Medicine and Clinical Pharmacology and Therapeutics, St James’s Hospital; Director, St James’s Lipid Clinic
  • Mr Pat O’Donnell, Patient representative and person with lived experience
  • Mr Scott Walkin, General Practitioner, Moy View Family Practice, Co. Mayo
  • Professor David Wood, Emeritus Professor of Cardiology, National Heart and Lung Institute, Imperial College London; Adjunct Professor of Preventive Cardiology, NIPC, University of Galway

Project funding

The position paper was commissioned by the National Institute for Prevention and Cardiovascular Health (NIPC) in partnership with the National CVD Prevention Council. It was written by The Health Policy Partnership in collaboration with the project steering committee, which held full editorial control over the content. The NIPC was supported in this initiative by unrestricted funding from industry partners: Novartis, Edwards Lifesciences and Bayer.

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