Hypertension is the most important single risk factor for cardiovascular disease (CVD). It affects over 25% of adults in England, but more than 5.5 million people remain undiagnosed. Although the number of adults with untreated hypertension has fallen, England’s performance still lags behind achievements in countries such as Canada and the USA, and there is scope for improvement.
The first Health Survey England (HSE) in 1994 revealed a ‘rule of halves’ since only half of people with hypertension were diagnosed, of which half were treated and of those, only half were controlled. Have matters improved over the more than 20 years since the first HSE survey?
Atrial fibrillation (AF) is the commonest sustained cardiac dysrhythmia, but is asymptomatic in about one quarter of patients. Case finding with subsequent assessment of the risk of stroke and bleeding are essential to ensure that the right patients receive appropriate intervention with oral anticoagulation.
The prevalence of atrial fibrillation (AF), together with the condition’s associated stroke and systemic thromboembolic risk, is increasing significantly. Fortunately, there are clear, evidence-based clinical guidelines and risk stratification tools, to ensure that patients can make informed choices about optimising their treatment and care.
In the first 15 months of its operation, Bradford’s Healthy Hearts campaign has significantly improved the cardiovascular health of local people, and saved an estimated £1.2 m for the clinical commissioning group.
Approaches to the prevention of cardiovascular disease should be tailored to each individual. But almost everyone will benefit from lifestyle interventions that have been shown to reduce cardiovascular risk.
In 2014, the Five-Year Forward View articulated clearly that, if the NHS is to be sustainable, it needs to get serious about prevention. The initial focus was on diabetes prevention; now the national prevention focus has switched to prevention of cardiovascular disease.
Cardiovascular disease (CVD) remains a significant cause of disability and death in the UK, and it is one of the conditions most strongly associated with health inequalities. We can help reduce the CVD burden by reminding our patients of the benefits of a healthy lifestyle.