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, and has produced Cardiovascular Disease Profiles for each PCT and Cardiac Network in England.
The Disease Management Information Toolkit from the Department of Health is designed to aid commissioning for long term conditions, including circulatory disease.
PCT Spend and Outcomes Factsheets based on Programme Budgeting data are published by YHPHO on behalf of the English PHOs
| | Morbidity and Hospital Activity |
General Practice Profiles contain information from the Quality and Outcomes Framework (QOF) dataset 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, local authorities and GP practices, 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 Compendium of population health indicators published by the NHS Information Centre contains many measures of circulatory disease morbidity and activity, including
- Deaths within 30 days of emergency admission to hospital: myocardial infarction
- Deaths within 30 days of emergency admission to hospital: stroke
- Emergency readmissions to hospital within 28 days of discharge: stroke
- Returning to usual place of residence following hospital treatment: stroke
- Vaccination: influenza for patients with coronary heart disease
- Vaccination: influenza for patients with stroke or transient ischaemic attack
Trends in circulatory disease mortality are included in Health Profiles.
The Compendium of population health indicators published by the NHS Information Centre contains many measures of circulatory disease mortality, including
- Mortality from all circulatory diseases
- Mortality from acute myocardial infarction
- Mortality from coronary heart disease
- Mortality from hypertensive disease
- Mortality from ischaemic heart disease other than acute myocardial infarction
- Mortality from stroke
- Years of life lost due to mortality from all circulatory diseases
- Years of life lost due to mortality from coronary heart disease
- Years of life lost due to mortality from hypertensive disease
- Years of life lost due to mortality from stroke
The Health Inequalities theme in Fingertips contains premature (aged <75) mortality from all circulatory disease for Local Authorities and PCTS, including comparison between mortality in the most deprived fifth of the population and the rest.
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.
Other useful reports