A new coalition led by Public Health England (PHE) and NHS England has announced the first ever national ambitions to improve the detection and treatment of atrial fibrillation, high blood pressure and high cholesterol (A-B-C) – the major causes of cardiovascular disease (CVD).
Detecting and treating these conditions can prevent or delay the onset of CVD, but they often carry no symptoms meaning millions are unaware they are at risk and in need of treatment. Over 5 million people are currently living with high blood pressure undiagnosed in England alone. By 2029, PHE and NHS England want:
- to detect and treat millions more people living with high blood pressure who are currently undiagnosed; currently, just over half (57%) of those with high blood pressure have been detected (6.8 million people) – the ambition is to increase this to 4 in 5 people (80%)
- to ensure three quarters (75%) of 40- to 74-year-olds have received a formal CVD risk check and have had their cholesterol levels recorded; currently fewer than half (49%) of those eligible for a formal check have received one (7.6 million people)
- to increase from 35% to 45% the proportion of 40 to 74 year olds at high risk of developing CVD who are treated with statins
The A-B-C conditions can be detected through routine checks across community and healthcare settings. The ambitions include recommendations for decision makers and frontline professionals on getting more people checked and best practice for identifying and treating those already at risk. People aged between 40 and 74 are also being urged to get their free NHS Health Check, which helps detect the early warning signs of CVD. The ambitions seek to build on the vital work being carried out by local authorities to deliver the check, which has reached millions of people.
Duncan Selbie, Chief Executive, Public Health England, said:
Know your numbers and save your life. We know our PIN numbers but not the numbers that save our lives. Thousands of heart attacks and strokes can be prevented by more people knowing their blood pressure and cholesterol numbers and by seeking help early. Prevention is always better than cure.
CVD is the leading cause of premature death and disability in England, causing a death every 4 minutes. Achieving the national ambitions would help meet the long term plan target to prevent 150,000 heart attacks, strokes and cases of dementia within a decade.
Professor Stephen Powis, NHS Medical Director, said:
This shows the fantastic commitment being made by this coalition to identify and treat heart disease and stroke which are top priorities in the NHS Long Term Plan. These ambitions will save thousands of lives by identifying and targeting people most at risk of these preventable conditions.
The ambitions also commit to reducing the health inequalities associated with CVD, with people in the most deprived communities four-times more likely to die prematurely from CVD than those in the least deprived. Health inequality data on each of the high risk conditions and tailored plans to address them will be published by 2021.
Health Secretary Matt Hancock said:
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. Almost half of those with high blood pressure are going about their daily lives without it being detected or treated. 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.
The NHS Long Term Plan has a target to prevent 150,000 heart attacks, strokes and cases of dementia within 10 years. By coming together across the system to agree these ambitions, we have set the goal posts for how we will achieve this target and continue our fight against the nation’s biggest killer.
To see the ambitions in full read the CVD edition of Health Matters and download the infographics.
Professor Jamie Waterall, National Lead for Cardiovascular Disease at Public Health England and Chair of CVD Prevention Forum, said:
Millions are unaware that they are living with these serious but treatable conditions. Detecting them early will help avoid thousands of heart attacks and strokes, the majority of which are preventable. If you’re between 40 and 74, get your free NHS Health Check to find out if you’re at risk and how this can be lowered.
Simon Gillespie, Chief Executive of the British Heart Foundation, said:
Heart and circulatory diseases are responsible for one in four deaths in this country, so improved detection of the major risk factors will play a critical role in the fight to save lives. If these ambitions are made a reality, the prospects of millions of at-risk people will be transformed.
For this to happen we must embrace innovative approaches so those at greatest risk of developing these conditions are identified at an early stage – making it as routine to know your numbers as it is to know your bank PIN number or weight. This means taking detection out into the community, making sure those with atrial fibrillation, high blood pressure or raised cholesterol have access to testing in local settings such as a supermarket or pharmacy. Those who do have one of these conditions will then able to get the treatment they need, and can be supported to self-manage on an ongoing basis.
Juliet Bouverie, Chief Executive of the Stroke Association, said:
We know that 9 in 10 strokes can, and should, be prevented. However, our research shows that if we don’t act now, then we can expect the number of strokes to increase by 44% in the next 20 years.
Every 5 minutes, stroke destroys lives. It can strike anyone – young or old. In England alone, there are around 5.5 million people with undiagnosed high blood pressure – ticking time bombs for stroke. Tackling this and atrial fibrillation (AF) would see the biggest drop in the number of strokes every year. We urge people to get their free NHS Health Check to test for these high risk conditions, prevent the devastation and disability that stroke causes, and avoid unnecessary cost to the NHS.
There are a number of ways people can take action to find out if they’re at risk:
- if you’re between 40 and 74, take up your offer of a free NHS Health Check, which will help you find out if you’re at risk of CVD and the support that is available to lower this risk
- if you’re over 30, take the Heart Age Test to find out more about the factors that affect your heart health; those under-30 can take the How Are You quiz for easy tips on healthy living
- everyone can find out about the different ways to maintain good cardiovascular health, such as eating well, staying active and cutting back on alcohol; free advice is available through PHE’s OneYou campaign
The National CVD Prevention System Leadership Forum is made up of over 40 member organisations covering government, NHS England, other arm’s length bodies, the third sector, Royal Colleges, clinicians and academia.