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Guest article: Marleen Kestens and Marilena Vrana, European Heart Network

The European Union Beating Cancer Plan is putting – rightly so – an important focus on disease prevention.  Prevention is far more cost efficient  than treatment and cure (needed in the case of cancer) or treatment and care (needed in the case of chronic diseases such as cardiovascular disease (CVD)). Cardiovascular disease is not only the EU’s number one cause of death, but also a leading cause of morbidity with more than 60 million EU citizens living with CVD, and close to 13 million new cases of CVD occurring every year.

Prevention is more important than ever

Although there is no specific EU cardiovascular health plan, the strong focus of Europe’s Beating Cancer Plan on primary prevention is most welcomed. CVD and cancer share many common risk factors, leading to millions of EU citizens disabled by ill-health before they even reach retirement age. The EU needs more than ever measures that reduce the exposure to the main risk factors, allowing its citizens to live more years in good health. Improving health literacy, providing access to healthy diets, improving infrastructure and urban planning to increase physical activity, achieving a tobacco-free Europe, reducing environmental pollution, and reducing harmful alcohol consumption are all policy areas that will not only benefit cancer reduction.  They will lead to a healthier society overall, as they will also help to reduce avoidable and premature deaths from all chronic diseases, not in the least cardiovascular diseases, and lead to a healthier society overall.

Prevention is only part of the solution 

However, the EU should not forget that not all diseases and mortality cases can be prevented.  In Finland, alone, for example, around 400 babies are born with congenital heart disease every year. Moreover, many heart diseases are also inherited (for example certain cardiomyopathies and arrhythmias), but most of those inherited diseases only become evident later in adulthood. Particularly now in times of the COVID-19 pandemic, cardiovascular complications linked to COVID-19 are wide-ranging and include incidence of thromboembolism, cardiac injury, arrhythmia, and heart failure, none of which can be tackled by primary prevention measures. Moreover, advances in oncological treatments have led to improved survival of patients with cancer.  Unfortunately, this has also increased morbidity and mortality of cardiovascular disease due to the cardiotoxicity of certain cancer treatments. At this moment, we witness an increasing number of patients developing both diseases or recovering completely from cancer but ending up suffering or dying from cardiovascular disease because of their cancer treatment.  This calls for urgent action and focused research on cardiovascular and cancer comorbidities and complications. Research funding for CVD is disproportionally low at EU level, compared with other diseases. The Horizon Europe Programme needs to prioritise research to achieve earlier recognition of cardiovascular disease and the development of innovative therapies addressing patients’ needs. EHN together with ESC, ECL, and ECCO is already working towards putting co-morbidities higher up the EU agenda, planning a joint meeting between the MEP Heart Group and the MEPs against cancer later this year.  

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