Heart health is a major concern in the UK with cardiovascular diseases remaining one of the leading causes of death. Worryingly, deaths from heart disease are rising for the first time in 50 years; arrhythmias are currently thought to affect over two million people in the UK and 1.5 million have Atrial Fibrillation (AF). Whilst there are key lifestyle issues and regional inequalities in the UK that are driving this downward turn, a significant contributing factor is outdated cardiac monitoring.
Many people rely on legacy tech and irregular check-ups meaning that early signs of heart problems often go unnoticed until they become much more serious. To address this issue, we need to make sure that procurement pathways are made as straightforward as possible for innovative monitoring tech to get to patients quicker.
Why heart health in the UK is so poor
With people living longer and unhealthy habits showing no signs of reducing, heart health in the UK has shifted.
The aging population means that more patients are now surviving conditions and there is a growing arrhythmias including both slow and fast heart rates in elderly patients.
A rise in obesity, which is strongly linked with cardiovascular issues such as coronary artery disease, heart failure, and arrhythmias, is increasing the risk of developing serious conditions. . According to NHS England, in 2023 to 2024, 64.5% of adults aged 18 years and over in England were estimated to be overweight or living with obesity. Whilst this is being somewhat curbed with the rise in GLP-1 patients, NHS access to these drugs is currently limited and will be a long-term solution.
Alcohol and smoking has since increased in patients since the COVID-19 pandemic that began during periods of isolation. These unhealthy lifestyle choices are enabling decaying heart health. Despite tobacco smoking rates falling, vaping is becoming more widespread. This is problematic as the long-term health effects are not yet fully understood.
With worsened heart health nationally and a lack of awareness on common heart risks, the care available to these patients for diagnosing comorbidities needs to be efficient and reliable.
Current disparities in cardiac care
There are also regional, demographic and ethnic disparities across the UK for the quality of cardiac care, including waiting lists and diagnosis times.
Regional variation in heart health often depends on socioeconomic status and attitudes towards illness, which creates a ‘postcode lottery’ for care. Patients from higher socioeconomic backgrounds tend to be more likely to seek medical advice when they experience irregular cardiac symptoms. They are proactive in monitoring their health using consumer devices with heart monitoring functions such as Apple watches, Fit Bits and Garmins. In these more affluent regions of the UK, patients also have better access to medical advice and innovative diagnostic technology which shields them from disparities. Their counterparts do not have the same access which leads to a gap in health outcomes.
Another significant issue is the gender gap in cardiac diagnostics. Heart disease is the leading cause of death for women in the UK with 3.6 million women living with the disease. Due to a lack of research, women’s symptoms are sometimes dismissed or attributed to other causes, such as menopause, despite post-menopausal women being at higher risk of developing coronary heart disease.
There are also significant ethnic inequalities in heart health, with certain ethnic groups facing a higher risk of cardiovascular disease and related deaths compared to others. Higher rates of some risk factors contribute to earlier and more severe disease in particular groups, such as those of South Asian ethnicity.
It is vital to recognise and tackle the deep-rooted disparities that exist across regions, socioeconomic backgrounds, gender, and ethnicity. Ensuring equal access to healthcare, improving awareness and understanding of heart disease in underrepresented groups, and tailoring approaches to the unique needs of different populations are essential steps.
The case for prolonged, wearable tech
A key factor for tackling inequalities is through prolonged wearable tech. This can expand access to high-quality diagnostics, reduce unnecessary hospital visits and ease pressures on NHS cardiology services. The NHS 10 Year Plan highlighted wearables as a key transformative technology, and aims to make wearables the standard in preventative, chronic and post-acute NHS treatment by 2035.
For too long, doctors have relied on outdated, cumbersome heart monitoring equipment with low sensitivity and specificity. This legacy tech is unsatisfactory from a patient’s perspective, and the detection rate is low, often missing infrequent or unpredictable arrhythmias. There are now far more innovative solutions with proven benefits for patients such as prolonged 2-week ECG patches.
2-week ECG patches are favourable as many arrhythmia symptoms are sporadic and unlikely to be captured during short-term monitoring. Longer, comfortable monitoring dramatically increases diagnostic yield especially during the second week of use. The introduction of prolonged monitoring patches has transformed the experience of cardiac monitoring for patients as they are comfortable, unobtrusive and allow individuals to maintain their normal routines.
Wearable patch technology has also significantly reduced the burden on clinical staff as devices can be posted directly to patients. The data is then analysed using advanced AI and generates clear, tailored reports for clinicians. The use of sophisticated AI algorithms ensures that arrhythmias are identified with a high degree of accuracy This streamlined process saves considerable time for healthcare professionals, enabling them to focus on higher-level clinical decision-making.
Red tape is delaying cardiac innovation
However, the bureaucratic processes within the NHS often cause significant delays in adopting new technologies and care pathways, leading to siloed cardiology care and patient disengagement.
Even when innovative solutions have proven benefits, the need to secure new funding codes and navigate administrative hurdles means it can take years for improvements to reach patients, ultimately slowing progress in cardiology services. To address this, the NHS should provide clear national commissioning guidance and align reimbursement for prolonged ambulatory ECG monitoring. This will give Integrated Care Boards the confidence to scale and adopt more accurate and quick diagnostics.
It is crucial that we improve how we monitor heart rhythms by adopting innovative monitoring technology in the NHS. Whilst patients need greater awareness around lifestyle habits that are negatively impacting heart health, we need to focus on getting new devices to patients faster to tackle the problem head-on.
By Professor Jay Wright, Consultant Cardiologist at Liverpool Heart and Chest Hospital and iRhythm advisor.