THE number of men in Scotland dying as a result of heart disease and heart failure rose to its highest level in a decade during the pandemic.

A new report from Public Health Scotland shows that there were 4,545 deaths among men of all ages from heart disease, heart failure or heart attacks combined in 2021.

It is the first time since 2012 that the number of deaths has exceeded 4,500.

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While most of the increase has been driven by an ageing population, the figures show that the mortality rate from heart failure among men jumped by 40 per cent between 2019 and 2021 even after adjusting for changing demographics.

Heart failure means that the heart is unable to pump blood around the body properly.

It is most commonly caused by coronary artery disease, where fatty deposits build up in the arteries reduces blood flow, but can also be triggered by high blood pressure, a previous heart attack, or a virus which leads cardiac muscle to become weak or stiff.

HeraldScotland: The mortality rate from heart failure in Scotland has increased since 2019, particularly for malesThe mortality rate from heart failure in Scotland has increased since 2019, particularly for males (Image: PHS)

The PHS report shows that the age-standardised mortality rate from heart failure among men in Scotland had fallen steadily from 10.7 deaths per 100,000 in 2012 to a low of 6.6 in 2019, before rebounding to 7.5 deaths per 100,000 in 2020 and 9.3 deaths per 100,000 in 2021.

Men over 75 account for around a three quarters of male heart failure deaths in Scotland, but the change in mortality rates was most obvious among those aged 45 to 74.

Between 2019 and 2021, the mortality rate climbed from 0.3 to 1.5 per 100,000 in the 45-64 age group, and from 6.1 to 11.2 per 100,000 in the 65-74 age group.

The increase may be partly skewed by comparatively small numbers, however, with a total of 19 heart failure deaths among men aged 45 to 74 in 2019 versus 43 in 2021.

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Covid has been associated with damage to the heart and increased risk of blood clots - which can lead to heart attacks - but it is unclear whether the pandemic has played a direct role in the figures.

The PHS report notes that progress in tackling cardiac-related deaths was stalling before Covid, stating that "whilst there has been a 19% reduction in deaths from coronary heart disease in Scotland over the last ten years, the rate of decline has slowed in the last five years".

 

 

Survival in the first 30 days following a heart attack is also "largely unchanged over the past decade", said PHS.

Stroke campaigners also voiced concerns that people in Scotland continue to be much more likely to suffer a stroke compared to people in other parts of the UK, although the gap in the mortality rate between Scotland and England is around a quarter of what it was in 1969.

The figures from PHS also show that that the number of men in Scotland suffering a fatal stroke climbed from a low of 808 in 2019 to 915 in 2021.

The mortality rate - adjusted for age - also increased, from 37.5 to 40.9 deaths per 100,000 - up 9%. However, this compares to 49.8 per 100,000 in 2012.

HeraldScotland: Male mortality rates from stroke have increased slightly since 2019Male mortality rates from stroke have increased slightly since 2019 (Image: PHS)

John Watson, associate director for the Stroke Association, said: “Stroke rates in Scotland are a third higher than for the UK as a whole.

"We need to see much faster progress if we are to reduce the devastating personal cost of stroke and bring Scotland more in line with its neighbours.

“Worryingly, this report shows that stroke incidence amongst men has actually increased slightly.

"And those in the most deprived areas are almost twice as likely to be discharged from hospital with a stroke, a gap that has widened in the last year."

Mr Watson said the charity wanted to see "concerted action to address Scotland’s unacceptably high stroke numbers", including increased awareness of undiagnosed atrial fibrillation - a form of irregular heartbeat that significantly increases stroke risk.

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Jane-Claire Judson, chief executive of Chest, Heart & Stroke Scotland, said the growing number of strokes and heart disease cases means there will be "rising demand for support to help people rebuild their lives once they get home from hospital".

She added: “People tell us that when they leave hospital is when they feel most scared and alone.

"That has very real consequences for their health and pressures on local health and care services. We need to see bold action to stop the crisis in community care from escalating."

It comes as senior dentists have warned the system in Scotland is "broken" after separate statistics from PHS revealed declining attendance rates - particularly among the most deprived communities.

HeraldScotland: Figures for September 2022 suggest that children living in the most deprived areas were least likely to see a dentist in the previous two years. The gap in participation rates for the most and least deprived has widened from three percentage points in 2008 to 20 percentage points in September 2022Figures for September 2022 suggest that children living in the most deprived areas were least likely to see a dentist in the previous two years. The gap in participation rates for the most and least deprived has widened from three percentage points in 2008 to 20 percentage points in September 2022 (Image: PHS)

While 95.4% of the population were registered with an NHS dentist at the end of September, only half had actually seen a dentist within the past two years compared to around 70% in 2019.

The gulf in participation rates between the most and least affluent is also the widest on record, with children and adults from the poorest areas respectively 20% and 11% less likely to have seen a dentist on the NHS.

David McColl, chair of the BDA's Scottish Dental Practice Committee, said: "Patients in Scotland's poorest communities are paying the price for the crisis in dentistry.

"The Scottish Government must not try to hide behind positive sounding registration figures. The reality is patient participation remains on the floor and inequalities are set to widen.

"Dentists are reconsidering their futures working in a broken system. NHS dentistry is on the critical list, and real reform won't wait."