Adnkronos (Adnkronos) – "Cardiovascular problems are the leading cause of death, but also the leading cause of disability, given that stroke is associated with them. In the case of heart failure, we're talking about an epidemic because it affects approximately 1,5% of the population. In Italy, there are approximately 800-900 cases, but considering that the incidence increases with age, as the population ages, the numbers are destined to continue to rise.
"Longevity is increasing, but we haven't yet been able to push cardiovascular disease to later in life, and so we have more people who develop heart disease and then are prone to heart failure," said Massimo Grimaldi, president of ANMCO (the National Association of Hospital Cardiologists), emphasizing that, as a scientific society, "we have always tried to optimize hospital pathways for patients with heart failure and raise awareness of this disease, which, unfortunately, is no less serious than cancer."
Lately, "we've been focusing heavily on continuity of care even after the acute phase, to ensure continuity of care between the hospital and community cardiology departments," Grimaldi explains. "We also continuously analyze the quality of care in Italy.
In a study we recently conducted—Bring-up Heart Failure—with the Anmco Foundation for Your Heart Ets, we found that a very high percentage of patients treated in Italian cardiac hospital departments have access to all four essential heart failure medications, at appropriate doses. Compared to other European averages, the percentage of patients receiving adequate therapies and on target dosages is truly excellent in our hospital setting.
The problem is then continuing to follow these patients in the local area."
These are "often complex patients," the expert specifies, "who require genuine care, continuity between hospital centers, outpatient cardiology, and general practitioners. In some cases, rehabilitation can also play a very important role. All the facilities serving the community are important, starting with general practitioners and outpatient specialists, and it's even better if they are united in a single physical location, namely the Community Center."
The concept of patient care "works if the patient is monitored over time," Grimaldi emphasizes. "Therapies evolve, but they must also be adjusted to the individual, and dosages may also change over time due to blood pressure fluctuations, weight loss, or the onset of new problems such as diabetes or kidney failure. Heart failure is characterized by the individual's inability to perform normal functions due to shortness of breath," explains the president of the National Heart Association (ANMCO). "Based on the level of exertion at which dyspnea occurs, heart failure is classified into four categories, according to what is known as the New York Heart Association class. Class one is no dyspnea, class two is for moderate-intense exertion, such as climbing stairs or walking at a very fast pace, class three is dyspnea with light exertion, such as walking at a normal pace, and class four is dyspnea at rest."
It's important to "raise awareness among the population. Many are terrified of cancer, but even today, people die more and become more disabled from heart disease: unfortunately, it's no less serious. Initiatives like 'Fism for People' are of great value," says Grimaldi, referring to the Cagliari leg of the initiative promoted by the Federation of Italian Medical-Scientific Societies to bring prevention ever closer to citizens through a community-based healthcare model.
"Prevention should be comprehensive. Instead, we have free screenings for breast cancer and colorectal cancer in the LEA (Emergency Health Assistance Program), but no free screening for cardiovascular disease, which is much more common and, in many cases, even more lethal. We should first screen for known risk factors and then perform an electrocardiogram, which can provide a wealth of useful information for early detection of certain diseases. Today, artificial intelligence has also significantly enhanced the ECG's diagnostic power." Local awareness initiatives, he concludes, "encourage the population to take care of their hearts before the disease manifests itself. Because the earlier we adopt healthy lifestyles, proper nutrition, and treat risk factors, the greater our chances of impacting our health. Every citizen should pay attention to their health, stay informed, and take the necessary precautions."
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