Cardiovascular disease a national call to action

The fight begins against the nation’s biggest killer. Prevention is better than cure.

That’s the message from the latest guidance jointly released today by Public Health England and NHS England.

They have agreed ambitions and a goal over a 10 year period to improve the detection and treatment of (A) atrial fibrillation, (B) high blood pressure and (C) high cholesterol the A-B-C of major causes of cardiovascular disease (CVD) in England.

It is estimated CVD costs the wider economy £15.8 billion per year and causes 1 in 4 deaths.

It’s well known that many people are living with undiagnosed CVD or if diagnosed it is badly managed. These conditions often carry no symptoms meaning millions of people are unaware they are at risk and in need of treatment. It is believed that over 5 million are currently living with undiagnosed high blood pressure in England alone.

Today CVD causes 1 in 4 deaths in England or 1 every 4 minutes. In 2016 heart disease was the leading cause of death for men and the second biggest for women after dementia.

The NHS long term plan (NHSLTP) has the ambition to prevent 150,000 cases of Strokes, heart attacks and dementia over the next 10 years.

The old adage prevention is better than cure is the mantra and Health Secretary Matt Hancock is on record as saying

“Prevention is at the heart of our vision for improving the health of the nation, empowering people to stay healthy, not just treating them when they’re ill. Millions of people are needlessly at risk of heart attacks or strokes when it could be prevented. So I want to help more people take the time out to protect their future health and get checked.”

These are the ambitions for Atrial Fibrillation (AFib) and Blood Pressure.

Atrial Fibrillation

  • 85% of the expected number of people with AF are detected by 2029
  • 90% of people with AF who are known to be at high risk of stroke to be adequately anti-coagulated by 2029.

Blood Pressure

  • 80% of the expected number of people with high BP are diagnosed by 2029
  • 80% of the total number of people diagnosed with high BP are treated to target as per NICE guidelines by 2029

How do we achieve these objectives when Primary Care is already overstretched?

By using the NHS Health Check to support early diagnosis and management can encourage people to make healthy life style choices such as eating well, reducing alcohol and taking more exercise is one approach.

New technology and new approaches can also help.

I’ve written previously on this Blog about opportunistic screening in different settings including community settings. Pharmacists for instance are already using new technologies and products like the AliveCor Kardia Mobile ECG and A&D UA-767 S blood pressure monitor with AFib + technology to actively and opportunistically identify at risk patients.

Already used extensively throughout the NHS the Kardia Mobile ECG monitor is clinically validated and automatically detects AFib in 30 seconds. Its quick uses a smartphone App and costs under £99.

Published today the CVD goals and ambitions Public Health England and NHS England hope to achieve by 2029 should be welcomed. If made a reality, the prospects of millions of at risk people will be transformed for the good.