BGS Cardiovascular SIG help launch Asian CardioGeriatrics Association

Dr Lara Mitchell is a Consultant Geriatrician at Queen Elizabeth University Hospital (QEUH), Glasgow. She is clinical lead for acute and has developed a frailty service. She is Chair of the BGS Cardiovascular SIG and tweets @laramitchdr

In December 2019 Dr Nigel Beckett and I from the BGS, along with Professor Jackie Taylor, President of RCP Glasgow, travelled to Macau for the Asian Pacific Advanced Heart Failure Forum (APAHFF). The event was hosted by Dr Eric Fung (Cardiologist) and Dr Victor Sim (Geriatrician). It was a high-calibre event profiling advances in research related to advanced heart failure and debilitating cardiovascular diseases. Victor, as some of you may know, recently retired from NHS Cardiff and Vale UHB where he co-led the Heart Failure service and the local Heart Failure MDT, to take on a full time education role in Hong Kong.

The Asian CardioGeriatric Association was launched at the start of the conference by Professor Jackie Taylor. It was an honour and privilege to be part of this and spend time with passionate colleagues who are advancing cardiovascular health in the older adult across the world. Nigel and I spoke at a BGS-led session along with Hong Kong colleagues. Nigel talked about targets for hypertension in the older adult: ‘Are they a Hit or Miss?’ and I gave a practical lecture about the management of transient loss of consciousness in the older adult.

Hong Kong has a population of 7.5 million and there are currently 1.12 million people aged 65 years and above (16.1% or 1 in 6), with a projected increase to 2.58 million ( 35.9% or 1 in 3) by 2064. Hong Kong has a life expectancy of 84.7 years, the highest in the world, beating places such as Japan and Italy (the well-recognised ‘blue zones’). Blue zones is the term that refers to geographic places in the world in which people have low rates of chronic disease and people live longer than anywhere else. They were first described by Buettner and colleagues as five areas in the world; Icaria (Greece), Sardinia (Italy), Okinawa (Japan), Nicoya peninsula (Costa Rica) and California (USA). In the Blue Zones genetics only account for 20% of the longevity and environment; diet and lifestyle play the biggest part in determining your lifespan!

In Hong Kong the reasons for this are multifactorial - the dense compact environment with open spaces meaning the older people can keep active; easy access to medical facilities; the traditional Chinese culture of caring, the Chinese diet and Tai Chi are all contributors to this. However, whether this will hold fast is uncertain with the increasing outlets supplying Western fast food and potential socio-economic change arising from political unrest which will need to play out.

Hong Kong’s healthcare system is underpinned by a robust public sector and a burgeoning private sector which operates along a dual track. 51% of doctors work in the public sector, which dominates secondary and tertiary care.

There are 165 doctors in Hong Kong who hold the specialist title of Geriatrician. The Hong Kong Geriatrics Society (HKGS) is extremely active, organising monthly meetings, inspiring juniors and educating colleagues about the management of the older person. Their vision is that every older person in Hong Kong should receive high-quality person-centred care with improved quality of life. There is not however the subspecialisation that there is the UK.

We also had the chance to meet Geriatrics colleagues from Thailand; similarly to Hong Kong, 16% of their 66 million population are aged more than 60 years. They currently have a life expectancy of 75.5 years – this has increased by more than 20 years since 1988. By 2031, 28% of the population will be older adults. There are only 50 Geriatricians throughout the entire country.

The Asian CardioGerdiogeriatric Association is planning to collaborate with the HKGS and raise the profile of cardiovascular health in Asia Pacific. They are keen to publish practical and concise guidelines for managing common cardiovascular diseases in the older adult. As members of the BGS Cardiovascular SIG, we will continue to encourage the development of the Asian CardioGeriatric Association and the Hong Kong Geriatrics Society.

We would encourage colleagues overseas to access a wide range of relevant information via the BGS website, to join the BGS as an overseas member and to consider submitting research papers to Age and Ageing.