The aim of the summit is to establish a healthcare system which is more able to deal with preventable illnesses such as diabetes, heart and lung diseases, some cancers and mental illness.
One topic of discussion will be health promotion through the healthcare system in order to avert some of the deaths from preventable illnesses which are expected to reach 1.5 million in the next 15 years.
The federal Health Minister Nicola Roxon, Victorian Health Minister Daniel Andrews, National Aboriginal Community Controlled Health Organisations chairman Dr. Mick Adams and National Heart Foundation chief executive Dr. Lyn Roberts, are all expected to speak.
Experts say chronic diseases account for the majority of deaths in Australia, and preventing them would lead to huge savings in government expenditure which costs more than $50 billion each year and would improve productivity.
A new government-commissioned report has estimated that the cost of alcohol, tobacco and illegal drug use, at $56-billion a year and serves to emphasise the need for investment in preventative health; tobacco control measures, have reportedly already saved the health system as much as $500 million a year.
Professor Mike Daube, the President of the Public Health Association says Australia is facing a tidal wave of preventable disease and 50 per cent of cancers and heart disease and 90 per cent of type-2 diabetes, are preventable.
Mike Daube is Professor of Health Policy at Curtin and he says the success in reducing smoking shows what can be done in the community with regard to issues such as obesity and alcohol.
Professor Daube was Western Australia ™s first Director General of Health and Chair of the National Public Health Partnership, has held a number of senior positions in government and is on a number of boards and committees involving heart health and smoking.
The summit findings will be passed on to the 2020 Summit, to be held in Canberra on April 19 and 20, and also to the new Health and Hospitals Reform Commission and the new National Preventative Health Taskforce.
The first study, led by Princy Thottathil, found that patients with LQTS that also have asthma, and that receive standard asthma treatment with stimulants to clear airways (e.g. beta-agonist therapy), have approximately twice the risk of having their first LQTS-related cardiac event (fainting, aborted cardiac arrest or sudden death) as the average patient. Conversely, those treated with beta-blocker therapy to address their arrhythmia risk, along with beta-agonist therapy for their asthma, enjoyed an 80 percent reduction in cardiac events (HR = 0.14; P = 0.05).
Past studies have suggested that treatment with beta-blockers, widely used hypertension drugs, is prudent as a preventive measure in all LQTS patients. The study examined 3,287 patients enrolled in the International LQTS Registry. Statistical analysis used to assess the independent contribution of clinical factors for first cardiac events from birth through age 40. Beta-agonist therapy for asthma was associated with an increased risk for cardiac events (hazard ratio [HR] = 2.00, 95% confidence interval 1.26-3.15, p = 0.003) after adjustment for relevant covariates including time-dependent beta-blocker use, sex, QTc, and history of asthma. This risk was augmented within the first year after the initiation of beta-agonist therapy (HR = 3.53; p = 0.006). The combined use of beta-agonist and anti-inflammatory steroids was associated with an elevated risk for cardiac events (HR = 3.66; p < 0.01).
In the second study led by Jehu S. Mathew, researchers found that going through menopause provided LQTS patients with a four-fold reduction in risk of cardiac events, providing further evidence that estrogen levels affect event risk. Past studied have determined that the risk of events is highest for women during child-bearing years, when estrogen levels are, on average, higher, and highest during the year a woman gives birth. The study involved 1,624 women, with 560 having undergone menopause (average age: 47). The primary endpoint was the occurrence of any cardiac event between the ages of 20 and 70 years. When assessing annualized cardiac event rates, meaningfully lower cardiac event rates were seen after menopause. This held true when patients were grouped by prior syncope, by QTc length and by genotype.
The last study, led by Edward Y. Sze, observed the effects of combining inherited risk for cardiac created by the LQTS syndrome with inevitable age-related heart disease. While most previous studies have focused on the course of LQTS on patients within the first four decades of life, the current study looked at risk in 641 patients aged 40 and older (with a QTc of greater than 449ms). Patients were identified as having coronary disease if they had a history of hospitalization for myocardial infarction, coronary angioplasty, coronary artery bypass graft surgery, or were treated with medication for angina. LQTS-related cardiac events included the first occurrence of syncope, aborted cardiac arrest, or sudden cardiac death without evidence suggestive of an acute coronary event.
The study found that coronary disease, developed with age, was associated with a more than two-fold increase in risk of LQTS-related cardiac events (hazard ratio 2.24, 95% confidence interval 1.24-4.04, p=0.008) after adjustment for syncopal history before age 40, QTc, and gender.
This is the first study to demonstrate that coronary disease augments the risk for LQTS-related cardiac events in LQTS, Moss said. The findings highlight the need for more focused preventive therapy in LQTS patients above the age of 40. Inherited plus acquired disease is a bad combination.
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