Heart Disease and Stroke
Lead analysts: Julian Flowers and Hannah Walford
Although mortality from Coronary Heart Disease (CHD) in the UK is declining, it continues to be the most common cause of death. More than one in five men and one in six women die from the disease. Both morbidity and mortality vary geographically, with higher rates in the North of the UK compared to the South. There are also socio-economic and ethnic differences, with higher rates of CHD in manual workers compared to non-manual workers and higher rates in South Asians compared to the population as a whole.
Reducing CHD is a major public health focus with a national target of reducing rates by 40% by 2010 (based on Health of the Nation target from 1999). Primary prevention concentrates on altering modifiable lifestyle factors including diet, exercise and obesity as well as stopping smoking and reducing alcohol intake.
Public health also has a role to play in secondary and tertiary prevention including ensuring appropriate availability of medication as necessary and equity of access to high quality surgical procedures.
Stroke is the third biggest cause of death in the UK and the largest single cause of severe disability. Each year more than 110,000 people in England will suffer from a stroke which costs the NHS over £2.8 billion.
SEPHO is the lead public health observatory for Coronary Heart Disease and stroke.
The National Service Framework for Coronary Heart Disease (NSF CHD), published by the Department of Health in March 2000, sets out a strategy to modernise CHD services over ten years. It details 12 standards for improved prevention, diagnosis, treatment and rehabilitation and goals to secure fair access to high quality services.
The National Stroke Strategy, launched by the Department of Health on 5 December 2007, sets a clear direction for the development of stroke services in England over the next ten years.
The Department of Health have also pubished the Disease Management Information Toolkit to aid commissioning for long term conditions, including circulatory disease.
Other useful reports
| | Morbidity and Hospital Activity |
The primary care Quality and Outcomes Framework (QOF) dataset contains information on the diagnosed prevalence of CHD, hypertension and stroke, and the care that registered patients receive.
APHO have developed modelled estimates of the prevalence of CHD, hypertension and stroke. These estimates, available for PCTs and local authorities, are based on models derived from Health Survey for England data. The models take into account age, sex, deprivation, ethnicity and smoking status.
Hospital Episode Statistics can be used to measure morbidity and activity associated with circulatory disease.
The National Centre for Healthcare Outcomes Development (NCHOD) compendium of indicators contains many measures of circulatory disease morbidity and activity, including
The National Centre for Healthcare Outcomes Development (NCHOD) compendium of indicators contains many measures of circulatory disease mortality, including
ERPHO mortality standard outputs
Erpho's Health Inequalities Profiles for PCTs contain premature (aged <75) mortality from all circulatory disease for the most deprived fifth of the population, the least deprived fifth, the least deprived 80%, the PCTas a whole and the region.