Evidence in Practice

The Public Health England (PHE) action plan for 2017-181 outlined the scale of the cardiovascular disease (CVD) issue we face here in the UK. Affecting around 7 million people, CVD remains a significant cause of disability and death. In England, we know that it is responsible for one in four premature deaths and over a quarter of all deaths, which not only affect the individual but also their families, and impact the wider community too. Healthcare costs associated with CVD are estimated at £8.96 billion and non-healthcare costs at about £4.04 billion. 2 A recent report discusses the evidence for the success of population-based CVD prevention programmes in reducing the burden of illness for individuals and society.

The NHS Health Check is a national programme offering a health check-up every five years to adults in England aged 40 to 74 without a pre-existing cardiovascular condition. One of the largest prevention programmes of its type in the world, the programme is designed to help prevent and detect early signs of heart disease, stroke, kidney disease, type 2 diabetes and dementia. 1 This article reviews the evidence that has accumulated since the programme was established.

Stories in this Evidence in Practice include:

• Health survey for England, 2016: The good and the bad news
• Healthy lifestyle changes have a long-term benefit for type 2 diabetes prevention
• Weight loss diets reduce the risk of premature death for people with obesity
• Very low calorie diet can achieve a remission of Type 2 Diabetes
• Dash diet plus sodium reduction lowers systolic blood pressure
• Long-term follow-up underscores benefits of lowering LDL-C in CVD primary prevention
• Blood pressure self-monitoring is more effective with professional support
• AF and other chronic conditions = higher risk of death
• Clinical trials underestimate the real-world impact of Atherosclerotic CVD
• The burden of heart failure continues to rise in the UK

An 18-year UK study in more than 24,000 subjects shows the benefits of exercise in elderly patients. The EPIC Norfolk prospective population study showed that any physical activity in the elderly is better than none at all for reducing cardiovascular risk.

Between 2002 and 2014, the number of new cases of heart failure in the UK increased by 12% – from 170,727 to 190,798 cases, according to the most comprehensive review of heart failure statistics in the UK. The number of new heart failure cases in 2014 was similar to the combined number of new cases of breast, prostate, lung and bowel cancer (189,136 cases in 2014).

Misdiagnosis of diabetes subtypes is putting the health of people at risk to a new UK study. Researchers examined the primary care records of more than 2 million people, assessing the frequency of different types of diabetes and the accuracy of diagnosis. Particular focus was given to those who developed Type 3c diabetes.

Worldwide, there has been a more than ten-fold increase in the number of children and adolescents with obesity in the past four decades, increasing from 5 million girls in 1975 to 50 million in 2016, and from 6 million to 74 million boys, according to a new global analysis of trends in child and adolescent obesity in 200 countries.

Percutaneous coronary intervention (PCI) is not significantly better than a placebo procedure in improving exercise capacity or symptoms even in patients with severe coronary stenosis, according to new UK research. The ORBITA study is the first double blind randomised controlled trial to directly compare stenting with placebo in patients with stable angina who are receiving high quality drug treatment.