Hundreds of Scots face avoidable heart attacks and strokes

There was also a sharp fall in the numbers of people starting drugs, such as statins, for high cholesterol.

READ MORE: Excess deaths hit highest number since peak of pandemic in April 2020

Unless the NHS can identify these missing patients, the study predicts that a lack of treatment will result in 1,669 people developing cardiovascular disease within their lifetime which would have been prevented with timely intervention.

According to modelling - published in the journal Nature Medicine - this would result in an estimated 279 heart attacks and 425 strokes.

Breakdown of the reduction in new blood pressure lowering prescriptions across Britain compared to pre-pandemic, and projections of lifetime impact on cardiovascular disease and events (Image: BHF)

It comes as separate figures revealed that flu deaths in Scotland hit a 20-year high last week, while the number of excess deaths was the highest since April 2020.

Naveed Sattar, a professor of metabolic medicine at Glasgow University and co-author on the study, said the problem was continuing due to a reduction in face-to-face consultations.

He said: "During the first two or three lockdowns, clinics just stopped happening. Even now, a lot of the time when I'm doing clinics patients are only seen virtually.

"If you don't physically put a cuff on people's arm and get it measured you don't know whether they've got high blood pressure.

"We have to rely on individuals that they have their own home monitors - are they doing it correctly? Are they telling you the truth?

"We just haven't been picking up high blood pressure or cholesterol levels and reducing cardiovascular risk in the way we should, and for some of these risk factors what matters is the exposure.

"If someone gets a statin five years later than they otherwise would have, for example, that's five years of extra exposure to high cholesterol that would then accelerate development of the plaques that leads to heart disease or stroke."

READ MORE: A&E delays and excess deaths - what's really going on?

Prof Sattar, who runs an NHS cardiovascular prevention clinic Glasgow Royal Infirmary, said he would "absolutely" like to see a resumption of more face-to-face appointments if it can be done safely.

He said: "The authorities don't necessarily want people to start coming back into hospitals and providing a further source of infection that might transmit into wards - there is a difficult balance between communicable diseases like Covid and non-communicable, but I think as a model we should see more patients face to face for blood pressure."

Statistics show that hundreds more people than normal have died over the past year in Scotland from circulatory causes such as blood clots, heart attacks, and brain haemorrhages.

Prof Sattar said this could be partly due to missed medications, but that unhealthier lifestyles - including weight gain, increased alcohol consumption, and less exercise during the pandemic - would also be a factor.

There is also evidence that Covid infections make blood stickier and more prone to blood clots, increasing the risk of strokes for a prolonged period even after recovery from the virus.

Dr Sonya Babu-Narayan, a consultant cardiologist and associate medical director at the British Heart Foundation, said: “Yet again we’re seeing clear evidence of the major disruption to healthcare people in the UK experienced during the Covid-19 pandemic.

“But it’s not too late to limit the damage. These findings demonstrate how getting heart healthcare back on track can curb the additional strain that untreated risk factors such as high blood pressure would otherwise place on the NHS."

READ MORE: Why are Scotland's cancer deaths lower in 2022 than before the pandemic?

Elevated blood pressure is believed to contribute to around 10 million deaths globally every year.

Professor Bryan Williams, chair of medicine at University College London, said the findings "confirm what many of us have observed clinically in terms of interrupted access to chronic disease management during the pandemic".

He said: "This is likely to be a factor contributing to the reported excess deaths in the UK in the past 12 months, especially the less effective treatment of high blood pressure."

However, he added that it should be made easier for patients to provide accurate blood pressure readings without needing to visit their doctor.

He said: "Patients shouldn’t need to visit doctors to get their blood pressure checked and their treatment dispensed, there are much better and more efficient ways of doing this that would be more convenient and more effective for patients. 

"Perhaps that is the most important take away from this study."