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• CVD a leading cause of death worldwide
• 17.9 million deaths each year
• 31% of all global deaths
• England 1 in 4 deaths due to CV disease
• 1 death every 4 minutes
• From 2011 the rate of increase in life expectancy slowed for both sexes
• Improvements in heart disease mortality plateaued
• In 2016, leading cause death for men
• In 2016, second biggest cause of death for women
• 33,812 died from CV disease under the age of 75
• 6.8 million living with cardiovascular disease
• Poor cardiovascular health may lead to


  • heart attacks
  • strokes
  • heart failure
  • chronic kidney disease
  • peripheral arterial disease
  • vascular dementia
• More common if


  • male
  • older
  • severe mental illness
  • ethnicity is South Asian or African Caribbean
• More common in people from 'poorer' communities


  2016-17 premature death rates: Manchester (140.7 per 100,000) vs Mid Suffolk (37.0 per 100,000)
• Cost to NHS England: non-healthcare costs £15.8 billion, healthcare costs £7.4 billion
• Majority CVD disease is preventable
• Risk factors


  • obesity
  • physical inactivity
  • smoking
  • drinking at unsafe levels
• NHS aims to prevent 150,000 strokes, heart attacks and dementia cases over the next 10 years
• Improve detection and treatment of high-risk conditions

  • hypertension
  • high cholesterol
  • AF
• Treatment effective at preventing cardiovascular events

  • antihypertensives
  • statins
  • anticoagulants
• Problems due to late diagnosis, under treatment, and deprived communities 30% more likely to have high BP
• High BP is a major single risk factor for heart attack and stroke
• Atrial fibrillation


  Rapid, irregular heartbeat
• Atrial fibrillation is the most common heart rhythm irregularity
• Atrial fibrillation may cause blood clot formation
• Atrial fibrillation increases risk of stroke X5
• 40 AF-related strokes every day in England
• Anticoagulation effective treatment for AF patients at risk of stroke, reduce risk up to 66%
• Many AF patients not on anticoagulants or on ineffective treatment - aspirin
• Hypertension


  2nd largest global risk factor for disease and disability
• Hypertension causes half of all strokes and ischemic heart disease
• Hypertension biggest risk factor for CVD mortality and morbidity in England: 1 in 4 adults, 64,000 deaths in 2015
• Hypertension causes 1 million disability-adjusted life years and 179,857 years of life lost (Global Burden of Disease)
• Hypertension accounts for 12% of all visits to GPs, costs the NHS over £2 billion per year
• Estimated that a further 5 million have undetected high BP
• High cholesterol


  Characterised by build-up of fatty deposits in arteries, increases with age
• 1 in 3 patients with ischaemic heart disease due to high cholesterol
• High cholesterol causes 7.1% of deaths and 3.7% of disability-adjusted life years
• Familial Hypercholesterolaemia (FH)


  1 in 250-500, 130,000-260,000 people, if untreated 50% of men and 30% of women develop coronary heart disease by age 55
• Aim to lower cholesterol levels to reduce the risk of CVD through diet, stopping smoking, reducing weight, and use of statins