“Spending on cardiovascular disease treatment will not be sustainable in 50 years”

“Spending on cardiovascular disease treatment will not be sustainable in 50 years”

BarcelonaValenti Fuster (1943) is one of the world’s most authoritative voices in cardiology. He directs the Cardiovascular Institute at Mount Sinai Hospital in New York City—recently renamed the Mount Sinai Fuster Heart Hospital in his honor—as well as the Carlos III National Cardiovascular Research Center in Madrid. He has published thousands of articles in scientific journals, received numerous awards, and is the most cited government researcher in history. In addition to visiting patients and conducting research, Fuster also conducts health education for children and adults to promote healthy lifestyles and prevent disease.

the Cardiovascular diseases They are the leading cause of death worldwide. Attempts to reduce these indicators have been made for years, to no avail. Where are we now?

– We still have a very big challenge ahead of us. We are living a paradox, where technologies related to the world of health are advancing, we have better diagnostic tools, new treatments based on genetics, the emergence of artificial intelligence and other innovations that work very effectively, but nevertheless, deaths from cardiovascular diseases are high. On the rise.

Why does it increase?

– There are several factors at play. The new drugs that have come out are expensive and not everyone can afford them. These are treatments for heart failure or altered heart rhythms that are going very well, but two-thirds of the world cannot afford them. Another crucial element is the consumer society we live in. Current lifestyles lead to an increase in diabetes, high blood pressure and cholesterol, among other things, which increases the risk of cardiovascular disease. We have improved technology, yes, but there is a war going on and the consumer society is winning.

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How can this dynamic be changed?

– The key is education. We do a lot of outreach to children because if you start at an early age, when there is more flexibility, you can have a bigger impact. If children understand the importance of good nutrition, we move forward to cardiovascular disease in adulthood. Through preventive measures, people’s quality of life improves and mortality can be reduced. It has to be people who want to take care of themselves, and that can only be done through education.

What measures can be deployed to improve children’s education?

— It is essential that there are topics dedicated to health at the early stages, for example. We have to start from the bottom and work our way up. We have to get into schools, but we also have to work on it from the family and the workplace, so that there is a cultural change in terms of healthy eating, physical exercise, tobacco and alcohol consumption. If not, we will not succeed.

What would happen if there was no such change?

“I insist that society needs to understand that we have a major challenge here. As long as the prevalence of cardiovascular diseases increases, the mortality rate will also increase. Hospital expenses for treating these diseases have tripled in the last 15 years. If we do not stop it, there will come a time when the expenses will become unsustainable and the systems will not be able to bear them.


— Right now, the cost of caring for people with diseases is affordable, but I don’t know if it will be so in 50 years. Risk factors will increase. For example, diabetes will increase by 25% and high blood pressure by 30%, so the costs of care will be much higher; there will be many more patients. However, if we make a change from childhood, we will be able to prevent this increase and reduce the incidence of these diseases.

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Beyond education efforts, what can be done to improve indicators and reduce mortality rates?

– Continue research. We have to continue to advance technology while disseminating preventive measures. The idea is to start working with people before there is a risk factor for cardiovascular disease, but when it does appear, we have the best tools to ensure patient care. And it has to be done in a collaborative way.

Prevention and innovation?

– Exactly. Technology is essential, but there are other non-scientific aspects that need to be preserved. We need a very clear philosophy about what we want as humans, because I think there are innovations that replace cognitive creativity. I’m not against technology, but there is a danger here, especially for young people. Artificial intelligence is an amazing advance, but I don’t know how it will fit into the future.

How do you see the research being conducted in the country in the field of heart diseases?

— Everything has improved a lot in Spain. Clinical cardiology is done very well, there are great specialists, and research has made great progress. That’s why I combine my work in the United States with what I do here, at the Carlos III National Cardiovascular Research Center. I come about once a week. If it’s not good, it won’t come.

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