Cardiovascular disease in ‘tumultuous times’

Former US Food and Drug Administration Commissioner and Cardiologist, Dr Robert Califf, addressed the Irish Cardiac Society Annual Scientific Meeting on the topic of “tackling the tsunami of cardiovascular disease in tumultuous times”.

An Instructor in Medicine at Duke University, US, Dr Califf talked about how life expectancy in the US has been declining in recent years and how there is now increased obesity, blood pressure, and glucose intolerance in younger people.

He also noted how highly educated and urban populations have superior health statistics compared with poor, poorly educated, and rural populations.

Dr Califf argued that while “traditional disparities” in sex, gender, race, and ethnicity are important, they are “overwhelmed by the two big social determinants: Aggregate wealth and education. And those two are linked to where you live.”

He outlined how the “death gap is widening between rich and poor” and said wealth disparity today is where it was in the 1920s and is continuing to widen. Low access to primary care in the US is another factor impacting health outcomes.

Dr Califf highlighted the worrying forecast that by 2034 “diaper” or incontinence pads/wear in the US for older people will exceed sales for infants.

Finances, he said, were taking precedence over improved health outcomes for patients in the US. He warned that cardiovascular disease would continue to rise in the future and said a deficit in the cardiology workforce already existed.  

Dr Califf argued that the clinical trial system in the US was not moving fast enough to keep up with the pace of  technological advances and maintained that electronic health records would be essential in the future.

“The traditional medical establishment changes very slowly… but if you want to generate evidence quickly, you need digital information,” he said.

Dr Califf also highlighted the “huge problem” of misinformation in medicine and noted that while debunking untruths can take hours, misinformation, on the other hand, takes mere seconds. He argued that medical professionals needed to “do better” in tackling misinformation.