Head of the Cardiovascular Disease Prevention Programme, Public Health England
Over the last 40 years, there have been dramatic reductions in deaths from cardiovascular disease (CVD). A tremendous achievement in its own right, these reductions have also made a significant contribution to increases in life expectancy.
While this means that many of us will benefit from living longer, those extra years of life are likely to be spent in poor health. Unfortunately, CVD also has a role to play here, affecting the lives of nearly seven million people.
CVD doesn’t affect everyone equally. People living in England’s most deprived areas are disproportionately affected. It is also more common among men, older people, people with a severe mental illness and among South Asian or African Caribbean communities. This not only bears a great cost to those affected, but health care costs are estimated at £7.4 billion and those to wider society at £15.8 billion per annum.
CVD doesn’t affect everyone equally. People living in England’s most deprived areas are disproportionately affected.
National CVD ambitions
Given that most CVD conditions are preventable, there is a considerable opportunity to make a difference. Bringing together over 40 health and social care partners, Public Health England has facilitated the development of national CVD ambitions. These focus on improving the detection and management of three common CVD conditions: atrial fibrillation, high blood pressure and high cholesterol. Optimal management of these conditions can be very effective at preventing heart attacks and strokes. However, late diagnosis, under treatment and unwarranted variation in care is common.
Benefits of improving secondary prevention
PHE estimates show that if achieved within three years, at least 49,000 strokes and 32,000 heart attacks could be prevented, making a substantial contribution to NHS England’s commitment to save 150,000 heart attacks, strokes and cases of dementia over 10 years. Over 10 years, the societal return on investment is estimated to be £2.30 for every £1 spent, including the value placed on improved health.
England has the potential to become a world leader, but doing so requires action across the system. If we are going to make a difference, we cannot solely rely on overstretched GPs but need to utilse a range of delivery approaches, including:
- using the NHS Health Check to support early diagnosis and management;
- Integrated Care Systems developing and delivering new CVD prevention models of care;
- implementing NHS England’s RightCare CVD prevention pathway;
- using existing data to make the case for action;
- making positive behavioural changes for preventing CVD;
- raising public awareness of CVD risk factors and opportunistic detection.