New ambitions for cardiovascular disease prevention will 'prevent thousands of heart events'

Atrial fibrillation, blood pressure and cholesterol are named as the focus for cardiovascular disease prevention efforts in England.

26 February 2019, by Siobhan Chan

Pulse check

Tackling risk factors and conditions that put people at the greatest risk of a heart attack or stroke are the key to preventing cardiovascular disease (CVD), health leaders have said.

Atrial fibrillation (AF), blood pressure and cholesterol are known as ‘ABC’ conditions. These were named as the focus for prevention efforts at a Public Health England (PHE) conference - ‘Cardiovascular disease prevention: Saving hearts and minds’, held in Manchester.

Duncan Selbie, Chief Executive of PHE, said: “We have made great progress on the risk factors – sugar tax, reformulating food and tobacco control. Now we need to focus on physiological factors like AF, blood pressure and cholesterol.”

Better detection and management of these factors could help to meet the NHS England ambition of preventing 150,000 heart attacks and strokes over the next 10 years, he said.

Dr Matt Kearney, National Clinical Director for CVD Prevention at NHS England, said: “The NHS has realised the enormous scope for improvement. Treating these high risk conditions works –modifying physiological risks has a huge impact.”

National CVD ambitions

The National CVD Prevention System Leadership Forum (CVDSLF), of which the BHF is a partner, has agreed specific ambitions for the detection and management of the ABCs.

Jamie Waterall, National Lead for CVD Prevention and Associate Deputy Chief Nurse at PHE, introduced what he described as England’s first ever CVD ambitions at the event.

“It’s tremendous the NHS Long Term Plan has prioritised CVD prevention,” he said. “Now we have set quantifiable ambitions for reducing CVD inequalities.

“We have too many people dying of ill health because they’re not being managed optimally for AF. We have examples from countries like Canada who have seen significant improvements in detection and management of blood pressure. And we need to improve the number of people knowing and managing their cholesterol.”

In the next 10 years, the CVDSLF’s ambitions are to see an increase in the following, across England:

  • Detection rate of AF from 79% to 85%
  • Proportion of people whose AF is managed with anticoagulants from 84% to 90%
  • Detection rate of hypertension from 57% to 80%
  • Proportion of people with hypertension being treated to target (as per NICE guidelines) from 56% to 80%
  • Proportion of people aged 40-74 receiving a formal validated CVD risk assessment and having a cholesterol measurement recorded on a primary care data system from 49% to 75%
  • Proportion of people aged 40-74 who have a 20% or greater 10-year risk of developing CVD being treated with statins from 35% to 45%
  • Detection rate of familial hypercholesterolaemia from an estimated 5% to 25% (by 2024)

Source: PHE guidance

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New models of care

Dr Kearney acknowledged the hard work needed from all parts of the NHS to achieve this ambition - in particular, from stretched GP services.

“High risk conditions have no symptoms, and most patients [seen in primary care] have multiple conditions or different priorities. The barriers are considerable and substantial,” he said.

“We have to do things differently, with new models and pathways through primary care.”

New primary care networks, that aim to start recruiting 20,000 more primary care staff and real-time data provided through CVDPrevent, would help to address the ‘structural challenges’ that were a barrier to achieving the ambitions, he said. 

Would you like to find out how data can help to improve care for patients at risk of CVD?

The national CVD prevention audit for primary care can help. 

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