Care for heart disease should start before the first signs of illness and should not end when a patient leaves hospital, speakers at the patient session of the 19th National Congress of Cardiology said.
The Association of Patients Active in Healthcare (APAZ) is proposing changes to Ordinance No. 9 and the National Framework Contract. It says this would let people with heart failure be followed more closely after hospital treatment. The group also wants chronic kidney disease added to the National Prevention Programme for 2026–2030.
APAZ also calls for earlier detection of risk, equal access to prevention and better coordination between specialists. Nikolay Nedyalkov, deputy chair of APAZ, said: "Prevention must not stop at information campaigns and one-off tests. It must be constant and organised care."
Cardiologists Prof. Ivan Gruev, Assoc. Prof. Antonia Kisheva and Prof. Vasil Traykov discussed a special outpatient procedure for people with heart failure. Under it, check-ups, tests and changes to treatment would be done without admission to hospital each time a patient's condition gets worse. For suitable patients, intravenous diuretics, drugs that drain excess fluid, would be given under medical supervision to cut avoidable hospital stays.
Prof. Armen Postadzhian said that having no symptoms does not mean having no risk. High blood pressure, cholesterol problems, diabetes, smoking and a high body mass index are behind about 57% of new cardiovascular disease in women and 53% in men. The figures come from an international study published in the New England Journal of Medicine, in which groups of people were followed for ten years.
The professor said blood pressure should be measured regularly and LDL cholesterol should be monitored, because its effect builds up over the years. Smartwatches can hint at a problem, but they do not replace a validated cuff device, Prof. Postadzhian said.
Clinical social worker Alexander Milanov said patients do not stick to their treatment because they fear medicines, have money problems and face complex treatment plans. He said trust between doctor and patient, and support from family, are an essential part of care.
All speakers at the session agreed that early prevention, continuous follow-up and coordinated medical and psychological support are needed to prevent complications and help patients live better.