Saving Lives: Cardiovascular Disease and the NHS Long Term Plan

Saving Lives: Cardiovascular Disease and the NHS Long Term Plan

Responsible for more than a quarter of deaths in the UK, cardiovascular disease has been identified in the NHS Long Term Plan as the single biggest area where the NHS can save lives over the next 10 years.

What is cardiovascular disease? Cardiovascular disease includes any conditions which affect either the heart itself or blood vessels and can include:

  • Coronary heart disease
  • Heart attack
  • Heart valve disease
  • Heart muscle conditions such as heart failure
  • Inherited heart conditions such as hypertrophic cardiomyopathy
  • Congenital heart disease
  • Atrial fibrillation
  • Stroke
  • Transient ischaemic attack or mini stroke
  • Peripheral arterial disease
  • Aortic disease
  • Vascular dementia

It is responsible for more than a quarter of all deaths in the UK.

 

Coronary heart disease is the most common type of cardiovascular disease and is also the main cause of a heart attack. It is connected to vascular dementia – according to the BHF, those with a history of coronary heart disease are at least twice as likely to develop vascular dementia.

There is also a link between diabetes and cardiovascular disease as people with diabetes are at higher risk of developing coronary heart disease. Diabetes is associated with one third of heart attacks and one in four strokes in the UK.

 

Reducing the risk of cardiovascular diseases

Not all heart and circulatory diseases are preventable, but there are things you can do to reduce your risk. Prevention is better than cure when it comes to some forms of cardiovascular disease and the most effective way to reduce the risk of these is to implement long term lifestyle changes.

The National Institute for Health and Care Excellence recommends that people at high risk of, or living with, cardiovascular disease should:

  • Stop smoking
  • Keep alcohol consumption within the recommended weekly limit
  • Eat a healthy, balanced diet with plenty of fruit and vegetables
  • Reduce their saturated fat intake
  • Replace saturated fats with unsaturated fat
  • Undertake at least 150 minutes of moderate intensity aerobic activity or 75 minutes of vigorous intensity aerobic activity or a mix of moderate and vigorous aerobic activity every week
  • Aim to achieve or maintain a healthy weight.

 

Cardiovascular disease policy

Prevention is a significant part of NHS England’s and Public Health England’s work on the condition. The NHS Long Term Plan has a key priority to detect patients at risk of cardiovascular disease, prevent and treat the condition. It says that it’s the single biggest area where the NHS can save lives over the next decade and aims to prevent over 150,000 heart attacks, strokes and dementia cases during the period.

Working alongside the NHS Long Term Plan is the National Cardiovascular Disease Prevention System Leadership Forum which aims to improve the detection and management of atrial fibrillation, high blood pressure and high cholesterol, which can lead to cardiovascular disease, as well as reducing the health inequalities.

It’s 10-year ambitions for cardiovascular disease include:

  • 85% of the expected number of people with atrial fibrillation are detected
  • 90% of people with atrial fibrillation who are known to be at high risk of stroke to be adequately anticoagulated
  • 80% of the expected number of people with high blood pressure are diagnosed
  • 80% of people already diagnosed with high blood pressure are treated to target
  • 75% of people aged 40 to 74 to have received a cardiovascular disease risk assessment and cholesterol reading in the last five years by 2029
  • 45% of people aged 40 to 74 identified as having a 20% or greater 10-year risk of developing cardiovascular disease are treated with statins.

 

Cardiovascular disease treatment

Statins are probably the most commonly known treatment associated with cardiovascular disease and the most commonly prescribed medication in the UK. They are used to lower ‘bad’ cholesterol or LDL (low-density lipoprotein) in the blood, reducing the risk of the build-up of fatty deposits in the arteries which can increase the risk of cardiovascular disease.

People who have had a heart attack or stroke are prescribed statins to reduce the risk of it happening again. People at high risk of cardiovascular disease are often prescribed them as they can lower the risk of a heart attack or stroke happening.

Other medications may include:

  • ACE inhibitors (angiotensin-converting enzyme inhibitors)
  • Angiotensin-II antagonists (ARBs)
  • ARNi (angiotensin-II receptor-neprilysin inhibitor)
  • Antiarrhythmic medicines
  • Anticoagulant medicines
  • Antiplatelet medicines
  • Beta-blockers
  • Calcium channel blockers
  • Digoxin
  • Diuretics

The British Heart Foundation has a lot of useful information on medication for heart conditions

www.bhf.org.uk


Sulakhan’s Story

In 2000, Sulakhan Singh Dard had a heart attack that required two heart operations including bypass surgery. He discovered his arteries had become blocked due to high cholesterol.

He explained: “Having a heart attack was very frightening. My son used to ask me about what I was eating, which was high in fat, but I felt I was a healthy man and not likely to have a heart attack.

“When I had the heart attack, I was very surprised to learn that it was due to high cholesterol. I don’t smoke or drink alcohol and I’m a vegetarian, so I thought I was healthy.

“My GP explained to me what high cholesterol was, and that it put me at further risk of stroke or vascular dementia. I didn’t want to have either of those, so I looked for ways to bring the cholesterol down.

“I sat down and analysed what I was doing and what I needed to do if I wanted to live. I understood that I needed to make some positive lifestyle changes and change my eating habits in order to improve my health. My family have supported me all the way.

“I now have less saturated fat, salt and sugar in my diet, and I eat things in moderation. I exercise daily, without fail. I walk over a mile every day, and I have joined a gym.

Gardening also helps to keep me physically active. I grow vegetables and have fruit trees which help with my healthy diet.

“Through healthy eating, regular exercise and medication I have lowered my cholesterol and managed to keep it under control.

“I feel more energetic, happier and in a way, I feel freer. I have a very positive outlook and I use my experience to help others.

“I volunteer up to 20 hours a week bringing awareness to the South East Asian community about how to live a heart healthy lifestyle. I say to everybody that if they have high cholesterol, they should do everything they can to bring it down and stay healthy.”


Sources

https://www.bhf.org.uk/what-we-do/our-research/heart-statistics

https://www.diabetes.org.uk/guide-to-diabetes/complications/cardiovascular_disease

https://www.gov.uk/government/publications/health-matters-preventing-cardiovascular-disease/health-matters-preventing-cardiovascular-disease#cvd-ambitions-and-secondary-prevention

https://www.gov.uk/government/publications/health-matters-preventing-cardiovascular-disease/health-matters-preventing-cardiovascular-disease

https://pharmafield.co.uk/healthcare/nhs-focus-on-cardiovascular-disease/

https://www.england.nhs.uk/rightcare/products/pathways/cvd-pathway/

https://www.england.nhs.uk/ourwork/clinical-policy/cvd/

https://publichealthmatters.blog.gov.uk/2019/02/14/health-matters-preventing-cardiovascular-disease/