Findings on smoking and heart attack spur call for better plan

Sharper focus on prevention and early diagnosis essential, says Irish Heart Foundation

A leading heart charity is urging the Department of Health to develop a fresh cardiovascular strategy following research that reveals increased risk of heart attack faced by smokers.

The call from the Irish Heart Foundation responds to an audit of heart attacks in Ireland between 2017 and 2020, which found current smokers were affected at much younger ages than non-smokers.

Examining data from some 5,600 heart-attack patients, the National Office of Clinical Audit (Noca) detected male smokers were, on average, aged 56 at the time of their major heart attack – known as ST elevation myocardial infarction or Stemi. The median age of non-smoking Stemi patients was 65.

There was a 16-year difference between the median age of female smokers who suffered a heart attack (60) and non-smoking women, who had a median age of 76.

Just over a third of all Stemi patients during the period were current smokers, compared to 17 per cent of the general population.

The foundation’s medical director, Angie Brown, said the current national cardiovascular health plan is out of date and requires review. It covered prevention, clinical management of cardiovascular disease and all aspects of heart health from childhood to old age, she noted.

It is “critical”, said Dr Brown, that a new policy increases the focus on prevention and early diagnosis.

A quarter of patients who had survived a previous heart attack continued to smoke, according to the Noca research. Dr Brown said the audit’s findings demonstrate a need for a “comprehensive and focused campaign” surrounding heart attack symptoms and risk factors such as smoking, she said.

Other risk factors identified by Noca were high blood pressure and high cholesterol, with 43 per cent heart-attack patients showing either or both. Diabetes had been diagnosed in 14 per cent of patients.

Seeking immediate help when symptoms of a heart attack begins leads to faster treatment and improved outcomes, according to the report. Only 37 per cent of patients suffering a Stemi sought medical assistance within an hour of symptom onset.

Patient representative Michael Madigan, who had a heart attack five years ago at the age of 48, credits as life saving his rapid 999 call and the decision of paramedics to transfer him by air ambulance from his Cavan home to the Mater hospital where there is a percutaneous coronary intervention centre.

Mr Madigan said it is important a symptom awareness campaign for heart attacks is as clear and memorable as that established for signs of stroke.

“A similar public message campaign to highlight the benefits of calling 999 immediately if you think you are having a heart attack . . . will be extremely effective,” he said.

Ellen O'Riordan

Ellen O'Riordan

Ellen O'Riordan is an Irish Times reporter