Cardiovascular disease (CVD) is an overarching term used to describe a family of diseases (including stroke, heart attack and peripheral vascular disease) which share a common set of risk factors.
Over 12% (53,100) of the population aged 16 and over in Warwickshire are estimated to be living with CVD, whilst 5.6% (24,600) of the adult population are estimated to be living with Coronary Heart Disease (CHD), and 2.6% (11,300) with Stroke alone.
In Warwickshire in 2013/14, there are over 27,000 patients on GP registers for stroke and CVD which suggests a notable gap between the estimated and observed prevalence. There are also over 83,000 patients with hypertension (high blood pressure – a common risk factor for CVD) equating to nearly 14.8% of the population, which is greater than the England proportion of 13.7%.
CVD is the second most common cause (after cancer) of death in Warwickshire accounting for approximately 1,400 deaths (27%) a year. The level of need varies depending on the diagnosis. CVD is a long-term, chronic condition. Yet in line with national trends, there continues to be an overall decline in the number and rate of deaths from CVD across Warwickshire.
Early mortality (under 75 years) rates from CVD in Warwickshire are significantly lower than the national rate, and have decreased by 40.% between 2002/04 and 2011/13. However, the latest under 75 mortality rate from all CVD is significantly higher in North Warwickshire Borough than witnessed nationally.
At CCG level, the breakdown of patient numbers on GP registers with stroke and CHD are:
- Coventry & Rugby CCG 4,500 (Rugby Borough only);
- South Warwickshire CCG 13,500
- Warwickshire North CCG 9,200.
Most deaths caused by CVD are premature and could be prevented by making lifestyle changes, such as eating a healthy diet, exercising regularly and stopping smoking.
There are also a number of other risk factors for CVD based on biological and social aspects of people’s lives, such as age, sex, ethnicity and deprivation. In addition, physical risk factors (including hypertension) reflect changes to body systems that are also reversible or preventable in their early stages, but which may require medical intervention and treatment.
In 2014/15, across the county, 682 health checks resulted in the diagnosis of previously unknown long term conditions.
There is considerable geographic variation across Warwickshire and by age and gender, in terms of CVD mortality. The 2011-13, under-75 mortality rate from CVD ranged from 58 per 100,000 population in Stratford-on-Avon District to 95 per 100,000 population in North Warwickshire Borough. Trends suggest a recent increase in the under-75 mortality rate for women in North Warwickshire Borough, although still similar to the England rate.
There is also notable variation across the County at GP practice level in terms of diagnosis and treatment.
The combined cost of CVD to the NHS and the UK economy is £30 billion annually. The cost of CVD to the UK healthcare system in 2006 was £14.4 billion (around 48%); productivity losses account for £8 billion annually (26%) and the cost of informal care of people with CVD is also £8 billion annually.
A CVD JSNA was not undertaken as the approach moved to placed based rather than thematic based needs assessments. Each place based needs assessment will look at the local picture of need for a wide range of measures, including CVD, giving a richer picture of local level requirements.