Throughout my professional career and from personal experience, I have witnessed the devastating impact cardiovascular disease (CVD) can have on individuals, communities and society as a whole. Despite significantly reduced death rates over the past couple of decades, this disease area remains the second largest cause of preventable ill health and death in England.
We also know it is a major cause of health inequalities, with people living in our most deprived communities almost twice as likely to die prematurely from CVD than those living in the most affluent. It is for all these reasons that Public Health England remains committed to prioritising our actions to prevent CVD, while working with others to make a bigger impact together.
We've published our ‘Action plan for cardiovascular disease prevention, 2017 to 2018’, which, showcases some of our existing programmes and resources, while highlighting some of the CVD initiatives taking place in the current tax year.
It is clear from over 1.4 million completions of our online Heart Age Test that people are concerned about their heart health, but more is needed at every level to help prevent the devastating impact of CVD.
Many don’t realise that over two thirds of premature CVD-related deaths or conditions are preventable by addressing risk factors such as smoking, obesity, high blood pressure, high cholesterol, excessive alcohol consumption and physical inactivity.
In 2016, we launched our first ‘Action on cardiovascular disease’ plan. Since then, CVD prevention has gathered momentum, with the NHS Prevention Board making it a priority and NHS England committing to further action in its Next Steps on the NHS Five Year Forward View.
Some key achievements in the past year include the launch of our Be Food Smart app – to help shoppers identify the salt, fat and sugar in their food – and our Smokefree NHS campaign to make our hospitals healthier. We have also partnered with the British Heart Foundation (BHF) to help support clinical leadership. CVD is a complex problem, so working with partners is essential to ensure the messages around prevention and treatment are reaching health and care professionals, as well as the general public.
We have made promising progress in pushing CVD further up the health and care agenda, but with 7 million people in the UK still affected, it is clear that more should - and must - be done.
For this reason, our 2017/18 prevention plan sets out clear actions for PHE and its stakeholders, to help us address CVD prevention across the life course and collectively prevent thousands of avoidable heart attacks and strokes.
The plan is aimed at those involved in the commissioning and provision of services for CVD and its prevention such as clinicians, local authorities, service commissioners, public health specialists, the third sector and PHE staff.
While by no means an exhaustive list, it highlights some of PHE’s critical work such as:
NHS Health Check
Early detection of risk is critically important in reducing the likelihood of developing cardiovascular conditions in the future. The NHS Health Check is designed to tackle the top 7 causes of preventable death and ill health by helping people to understand their individual risk.
More importantly, it helps them reduce their risk by modifying their lifestyle or receiving clinical treatments, such as cholesterol and blood pressure treatment. Almost 5 million checks have taken place since April 2013.
Next year, we hope to collect data from general practices across England, providing invaluable insight into the delivery of the NHS Health Check programme at a local level.
This will be world-leading in its aspiration to understand the key risk factors in our adult population. Crucially, it will also tell us how people are being supported to manage their risks through evidenced-based interventions, which will assist in reducing the number of avoidable heart attacks and strokes.
Air pollution may not seem like an obvious link to CVD, but we know it plays a part. We’re currently working with the Committee on the Medical Effects of Air Pollutants (COMEAP) to review the evidence linking air pollutants to effects on cardiovascular health.
The committee will also estimate the effect of long-term exposure to air pollution on cardiovascular conditions in the UK. PHE will work with local authority public health teams to support interventions that can potentially reduce exposure to air pollution and improve the public’s health.
Working with NHS England and partners to support improvements in detection and management of high risk conditions
PHE is supporting major initiatives to improve CVD prevention. This includes addressing the causes of poor health in 44 sustainability and transformation partnership (STP) areas across England, to help people lead healthier lives. We collaborated with NHS England and others to develop the NHS RightCare CVD prevention pathway, designed to help people get the right care, in the right place, at the right time.
Our new Size of the Prize resource presents opportunities for each STP to work differently to prevent many thousands of heart attacks and strokes, through evidence-based treatments for conditions such as high blood pressure, atrial fibrillation and high cholesterol.
Heart Age Test
A recent campaign to promote the Heart Age Test saw a surge in people taking the online test to find out their heart age. Over the course of the year, we’ll continue working to increase uptake of the test among those aged over 30, aiming to reach another million people. This will help people to think about important risk factors such as smoking and obesity, as well as encouraging them to know their blood pressure numbers and take action to manage these important risk factors.
We have come a long way in getting people to address CVD prevention – both in terms of more joined-up work between health professionals and organisations, as well as getting individuals to take control of their own lifestyle risks.
However, premature death and ill health from CVD haven’t gone away and some risk factors, such as obesity, are on the rise. Preventing CVD from occurring and addressing risk factors are crucial if we are to reduce the devastating impact on individuals and communities across the country.
We hope you find this publication useful and welcome your feedback and support in working on this important prevention agenda together.