The Government must do more to address inequalities in the health service amid evidence that rich people are more likely to receive NHS treatment for heart disease than poor people, according to the public spending watchdog.
An estimated 182,000 people in Scotland have coronary heart disease (CHD), around 3.3% of the population.
In some more deprived areas around 25% of men over 75 have CHD but, according to Audit Scotland, people in deprived communities "are not always getting the same level of treatment as the rest of the population".
Treatments such as angioplasty, which widens the arteries, or heart bypass surgery, are over 20% less than expected in deprived areas. The least deprived areas saw over 60% more than expected.
Audit Scotland said this "implies a lower level of access to these treatments for people in more deprived areas".
The report states: "The Scottish Government and NHS boards should monitor rates of the main cardiology procedures, compare these by board and by different groups, particularly in more deprived areas and with other countries, and review whether variation is warranted or if action needs to be taken to ensure patients are receiving the most appropriate treatment."
It adds that they must also "continue to improve the evidence base on the impact and cost effectiveness of measures to help prevent heart disease and use this evidence to identify priorities for spending to help improve outcomes and address inequalities, particularly in deprived areas".
The report found limited evidence of the effectiveness of the Government`s Better Heart Disease and Stroke Care Action Plan which set a national target for cardiovascular health checks.
It states: "It is not clear yet what the overall impact of these checks has been on the rates of heart disease, hospital admissions and deaths, although death rates have reduced in the 15% most deprived areas and the gap between the national average and the most deprived areas has narrowed slightly."
Rates of heart disease in Scotland remain the highest in Western Europe, despite new cases falling by nearly a third in the last 10 years. Death rates have reduced by around 40%.
