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Part of: Ill Health and Disability

Related to: Ageing Population, Alcohol, Diabetes, Dementia, Diet and Malnutrition, [[Health Checks]], Heart Failure, Hypertension, Major Causes of Mortality, Healthy Weight, Physical Activity, Smoking, Stroke, Food Poverty

Key Facts:

  • There were 5,824 people in 2012/13 (financial year) registered with coronary heart disease in GP practises in Bath and North East Somerset, with a rate of 2.9% of the registered population.
  • This rate is significantly lower than England which has a prevalence rate of 3.3%.
  • Emergency Admissions for men are significantly higher than rates for women.
  • Rates of CHD are strongly related to Socio-economic Inequality
  • Early Deaths due to Heart Disease are reducing in line with national figures.
  • premature deaths (in terms of potential years of life lost) from ischaemic heart disease is significantly lower in B&NES compared to national and regional averages.

Definition

Coronary heart disease is the term that describes what happens when your heart's blood supply is blocked or interrupted by a build-up of fatty substances in the coronary arteries. Over time, the walls of your arteries can become furred up with fatty deposits. If your coronary arteries become narrow due to a build-up of these fatty deposits, the blood supply to your heart will be restricted. This can cause angina (chest pains).If a coronary artery becomes completely blocked, it can cause a heart attack. 1

What does the data say?

Your risk of developing coronary heart disease is significantly increased if you:

  • smoke
  • have high blood pressure
  • have a high blood cholesterol level
  • do not take regular exercise
  • have diabetes
  • are obese or overweight
  • have a family history of CHD: the risk is increased if you have a male relative with CHD under 55 or a female relative under 65. 2

Coronary heart disease (CHD) is the greatest cause of mortality in the UK. Around one in five men and one in seven women die from the disease. CHD causes around 94,000 deaths in the UK each year. 3

In the UK, there are an estimated 2.6 million people living with the condition and angina (the most common symptom of coronary heart disease) affects 2 million people. CHD affects more men than women, and your chances of getting it increase as you get older. 4

Bath and North East Somerset

There are 5,824 people (2012/13 financial year) registered with coronary heart disease in GP practises in Bath and North East Somerset.* 5

The rate of coronary heart disease for the GP registered population of Bath and North East Somerset remained at 3% between 2008-2011(financial years), with a slight decline between 2011-2013 (financial years) to 2.9%.* 6

The rate of CHD in the GP registered population of Bath and North East Somerset has been significantly lower than England which has had a prevalence rate of 3.4% and above between 2008-2012, and 3.3% in 2012/13 (financial years) .*  7

coronary_heart_disease_qof_2008-2013_line_graph

Figure 1: Coronary heart disease prevalence in the B&NES GP registered population (2008/09 - 2012/13 financial years)  8

*It is important to note that the above rates are based on the GP registered population of Bath and North East Somerset and so some of these people may not be residents of Bath North East Somerset. Nevertheless, the vast majority of people will be registered with a GP in their county of residence.

For more up to date prevalence figures for coronary heart disease recorded as part of the NHS Quality and Outcomes Framework (QOF), see the Ill Health and Disability section. 

The observed rate for coronary heart disease in Bath & North East Somerset is 73% of the estimated prevalence. This compares to 72% for England. 9

The emergency admission rates for coronary Heart disease are lower than England and South West rates.

Admissions for men are significantly higher than rates for women; this represents true prevalence rather than a reporting gap.

Emergency admission rates for CHD are significantly higher for more deprived communities; however the gap has decreased significantly since 03/04. 10

In terms of potential Years of Life Lost (YLL), B&NES CCG has a significantly lower rate of annual years of life lost to ischaemic heart diseases compared to comparable rates for England and South West GOR - see Major Causes of Mortality (Premature Mortality) for further information.

Are we meeting the needs?

NHS Bath and North East Somerset is in-line regionally and above national with respect to the percentage of GPs prescribing low cost statins, which are used to treat cardiovascular disease (B&NES and South West 78%, nationally 76%). 11

Mortality from coronary heart disease in Bath and North East Somerset has decreased since 1993. 12

The mortality of CHD has decreased at a similar rate to comparators and is slightly lower than regional and national rates (1993 181.8 per 100,000 (523 persons) and in 2010 58.28 per 100,000 (201)) (nationally 74.2 per 100,000, regionally 64 per 100,000). 13

Mortality from CHD in the under 65’s is lower in Bath and North East Somerset than comparator areas and is also decreasing at a similar rate (1993 rate was 40.19 per 100,000 (57), 2010 was 8.56 per 100,000 (14)) (18.8 per 100,000 nationally, 14.8 per 100,000 regionally (2010)). 14

What can we realistically change?

By making some simple lifestyle changes, people can reduce their risk of getting coronary heart disease, or reduce the risk of developing further heart-related problems if they already have coronary heart disease. 15

The following is a summary of NICE (National Institute for Health and Clinical Excellence) guidance for the prevention of cardiovascular disease, including coronary heart disease at a regional and local level: 16

  • Gain a good understanding of the prevalence and incidence of cardiovascular disease (CVD).
  • Consider how existing policies relating to food, tobacco control and physical activity, may impact on the prevalence of CVD locally.
  • Gauge the community's level of knowledge of, and beliefs about, CVD risk factors.
  • Identify groups of the population who are disproportionately affected by CVD and develop strategies with them to address their needs, taking into account the community's exposure to risk factors.
  • Work with existing strategies for targeting people at particularly high risk of CVD and take account of ongoing, accredited screening activities by GPs and other healthcare professionals. This includes the NHS Health Checks programme.
  • Work closely with regional and local authorities and other organisations to promote policies which are likely to encourage healthier eating, tobacco control and increased physical activity. Policies may cover spatial planning, transport, food retailing and procurement. Organisations that may get involved could include statutory, public sector and civil society groups.
  • Identify people to lead the CVD programmes, including members of the local community. Identify in advance – and provide for – the training and other needs of these potential leaders.
  • Develop systems within local strategic partnerships and other subregional or regional partnerships for agreeing shared priorities with other organisations involved in CVD prevention. Ensure senior staff are involved, as appropriate.
  • Establish baseline measures before the CVD programmes begin. These should include lifestyle and other factors that influence cardiovascular risk, as well as figures on CVD prevalence and mortality.
  • Help children and young people to have a healthy diet and lifestyle. This includes helping them to develop positive, life-long habits in relation to food. This can be achieved by ensuring the messages conveyed about food, the food and drink available – and where it is consumed – is conducive to a healthy diet.
  • Encourage venues frequented by children and young people and supported by public money to resist sponsorship or product placement from companies associated with foods high in fat, sugar or salt.
  • Organisations in the public sector should avoid sponsorship from companies associated with foods high in fat, sugar or salt.
  • Ensure the need for children and young people to be physically active is addressed.