CVD Ambitions

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Public Health England Release CVD Ambitions
14/02/2019

First Ever National Ambitions To Tackle Major Causes Of Heart Attack, Stroke And Dementia

  • Public Health England and NHS England lead coalition of over 40 organisations, including Blood Pressure UK, to step up fight against the nation’s biggest killer
  • Tackling ‘A-B-C’ causes of cardiovascular disease will help meet Long Term Plan commitment to prevent over 150,000 heart attacks, strokes and dementia cases
  • New ambitions* include goal of detecting four in five adults with high blood pressure within a decade

A new coalition led by Public Health England (PHE) and NHS England has announced the first ever national ambitions to improve the detection and treatment of Atrial Fibrillation, High Blood Pressure and High Cholesterol (A-B-C) – the major causes of cardiovascular disease (CVD).

Detecting and treating these conditions can prevent or delay the onset of CVD, but they often carry no symptoms meaning millions are unaware they are at risk and in need of treatment. Over 5 million people are currently living with high blood pressure undiagnosed in England alone. i By 2029, PHE and NHS England want:

  • To detect and treat millions more people living with high blood pressure who are currently undiagnosed. Currently, just over half (57%) of those with high blood pressure have been detected (6.8 million people) – the ambition is to increase this to four in five (80%). ii
  • To ensure three quarters (75%) of 40 to 74 year olds have received a formal CVD risk check and have had their cholesterol levels recorded. Currently fewer than half (49%) of those eligible for a formal check have received one (7.6 million people). iii
  • To increase from 35% to 45% the proportion of 40 to 74 year olds at high risk of developing CVD who are treated with statins. iv

The A-B-C conditions can be detected through routine checks across community and healthcare settings. The ambitions include recommendations for decision makers and frontline professionals on getting more people checked and best practice for identifying and treating those already at risk. v People between 40 and 74 are also being urged to get their free NHS Health Check, which helps detect the early warning signs of CVD.

Professor Graham MacGregor, Chairman of Blood Pressure UK said: “We are delighted that Public Health England have included the important campaign to 'Know Your Numbers' in their CVD ambitions paper.  Thousands of heart attacks and strokes can be prevented by more people knowing their blood pressure numbers and taking action such as reducing salt intake, getting to a healthy weight, and doing more exercise."

Professor Stephen Powis, NHS medical director, said: “This shows the fantastic commitment being made by this coalition to identify and treat heart disease and stroke which are top priorities in the NHS Long Term Plan. These ambitions will save thousands of lives by identifying and targeting people most at risk of these preventable conditions.”

The ambitions also commit to reducing the health inequalities associated with CVD, with people in the most deprived communities four-times more likely to die prematurely from CVD than those in the least deprived. vii Health inequality data on each of the high risk conditions and tailored plans to tackle them will be published by 2021.

Health Secretary Matt Hancock said: “Prevention is at the heart of our vision for improving the health of the nation, empowering people to stay healthy, not just treating them when they’re ill. Almost half of those with high blood pressure are going about their daily lives without it being detected or treated. Millions of people are needlessly at risk of heart attacks or strokes when it could be prevented. So I want to help more people take the time out to protect their future health and get checked.”

*To see the ambitions in full read the CVD edition of Health Matters 

– ENDS –

1 NHS Digital (2018) Quality Outcomes Framework (QOF) 2017/18. Available from: https://qof.digital.nhs.uk/

2 Public Health England (2018). NHS Health Check data. Available from:

https://www.healthcheck.nhs.uk/commissioners_and_providers/data/

i Around 13m people have high blood pressure in England. Hypertension prevalence estimates for local populations (2016) https://www.gov.uk/government/publications/hypertension-prevalence-estimates-for-local- populations
ii 57% of the estimated number of adults (16+) with hypertension have been detected NHS Digital. Health survey for England (2017) https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for- england/2017

iii Data on the number of people who have had a CVD risk assessment and cholesterol reading is not currently collected. The percentage of people who have had these measurements is therefore estimated based on the number of people who have had an NHS Health Check in the latest 5-year cycle of the NHS Health Check (Q1 2013 – Q4 2018). In England, the percentage of people aged 40-74 who have had a cholesterol reading and CVD risk assessment is therefore estimated at 49%.

iv Of patients aged 40+ who were recorded on The Health Improvement Network (THIN) research database with a CVD risk score of ≥20% from 2012 to 2015, only 35% were initiated on a statin. Finnikin S, Ryan R and Marshall T. Initiations and QRISK2 scoring in UK general practice: a THIN database study. Br J Gen Pract 2017; 67 (665): e881-e887

3 NHS Digital. Health survey for England (2017). Available from: https://digital.nhs.uk/data-and- information/publications/statistical/health-survey-for-england/2017
4 NHS Digital. Hypertension indicator group, INLIQ, England, 2017-18. Available from: https://digital.nhs.uk/data-and- information/publications/statistical/gp-contract-services/gp-contract-services-england-2017-18
5 Collins GS, and Altman DG. ‘Predicting the 10 Year Risk of Cardiovascular Disease in the United Kingdom: Independent and External Validation of an Updated Version of QRISK2’. BMJ 344 (21 June 2012): e4181.
6 Public Health England (2018). NHS Health Check data. Available from:https://www.healthcheck.nhs.uk/commissioners_and_providers/data/
7 The Health Improvement Network (THIN) (2016) THIN research database 2012-15. Available from:https://www.iqvia.com/locations/uk-and-ireland/thin

8 Haralambos et al. (2018). Atherosclerosis. Familial hypercholesterolaemia (FH) genetic testing in the UK. Available from:

https://www.atherosclerosis-supplements.com/article/S1567-5688(18)30519-1/fulltextv Health professionals are being encouraged to implement NHS England’s RightCare CVD Prevention Pathway, underpinned by NICE guidance, to help improve the detection and management of Atrial Fibrillation, High Blood Pressure and High Cholesterol
vi British Heart Foundation (2018) CVD Statistics: BHF England Factsheet. (Last reviewed and updated November 2018). Available from: https://www.bhf.org.uk/statistics

vii Public Health England (2018) Health Profile for England 2018

https://www.gov.uk/government/publications/health-profile-for-england-2018/chapter-5-inequalities-in-health


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