Circulatory Disease

Introduction

Cardiovascular disease (CVD) refers to diseases of the heart or blood vessels.  Blood flow to major organs of the body may be reduced by formation of a blood clot or a build-up of fatty deposits inside an artery, leading to hardening and narrowing of the artery. The main diseases are:

  • Coronary heart disease – reduced blood flow in the coronary arteries which supply the heart with blood.
  • Stroke – reduced blood supply to the brain.
  • Peripheral vascular disease – blockage in the arteries to your limbs.

CVD is the leading cause of death in England and worldwide, accounting for a third of all deaths in England.  It is thought that most deaths due to CVD are premature and could be prevented by making a number of lifestyle changes including weight reduction, following dietary and physical activity recommendations, stopping smoking and moderation in alcohol consumption.  People at high risk of CVD are prescribed medication such as statins to reduce cholesterol level, aspirin to prevent blood clots and blood pressure medication.

For people suffering heart attacks, the median call to treatment time is lower than the national time.

There is a slightly higher proportion of stroke patients under 75 years discharged back to their usual place of residence compared to the national picture.

What are the big issues?

  • Mortality rates in Warwickshire from CVD are significantly lower than the national rate, and have decreased by 54.6% since 1995-7.  The absolute gap in CVD mortality, for persons under 75 years, between the most deprived and least deprived local areas has decreased by 24.5% between 2001 and 2009; but the relative gap has increased from 97.7% to 357.7% respectively.
  • The total cost of statin prescribing relative to the local population with CHD is higher compared to the national picture.
  • The prevalence of CVD increases significantly after the age of 40 years.  The percentage of the population aged 40 years and over is expected to increase in Warwickshire from 25.5% to 27.9% for males and increase from 27.2% to 28.2% for females by 2030.
  • Warwickshire has 4.3% of its population in the most deprived national quintile and 30% of the population in the least deprived quintile.  Deprivation is another key factor in CVD.
  • The proportion of the population in Warwickshire which is from black and minority ethnic groups is estimated to be 10.3%.  South Asian men are more likely to develop CHD at younger age, and have higher rates of myocardial infarction.  Black people have the highest stroke mortality rates.
  • Estimates from the Health Survey for England suggest 18.6% of the population in Warwickshire smoke and 22.4% binge drink.  Smoking and alcohol misuse increase risk of CVD.
  • 24.9% of the adult population in Warwickshire are obese, higher than the England average (24.2%).  Obesity and poor diet (independent of obesity) increase the risk of CVD.

What do we need to do?

  • Maximize the use of the QOF and other performance measures to improve quality;
  • Support GP practices at the lower end of the performance;
  • Implement the NHS Health Check programme to raise awareness of cardiovascular disease, improve health outcomes and reduce premature mortality;
  • Encourage lifestyle changes necessary for CVD prevention such as low salt and low fat but more fibre in food, increased physical activity and smoking cessation;
  • Address gaps in the diagnosis, management and access to cardiac services.

Who needs to know?

  • All general practices
  • District and Borough Councils
  • Food industry
  • George Elliot Hospital
  • South Warwickshire NHS Foundation Trust
  • Sports and recreational centres
  • University Hospitals Coventryand Warwickshire

Further information