Overview

1
Overview
2
Total mortality

• Cardiovascular disease (CVD) main cause of death
  in the UK
• almost 198 000 deaths / year
• accounts for 35 all death
• Main forms of CVD are CHD and stoke
• 48 of all CVD deaths from CHD / 28 from stroke
• CHD by itself most common cause of death in the
  UK
• around one in five men and one in seven women die
  from CHD
• CHD causes 94 000 deaths / year

England and Wales Office for National Statistics
2008 Scotland, General Register Office
2008 Northern Ireland, Statistics and Research
Agency 2008
3
Total mortality
Men
Women
9
16
13
BHF Statistics Database, 2005
4
Premature mortality

• CVD main cause of premature death (death before
  75 years) in the UK
• 30 of men and 22 of women premature death due
  to CVD
• CVD caused just over 53 000 premature deaths in
  2006
• CHD by itself most common cause of premature
  death in the UK
• 19 of men and 10 of women premature death due
  to CHD
• CHD caused almost 31 000 premature deaths in 2006

England and Wales Office for National Statistics
2008 Scotland, General Register Office
2008 Northern Ireland, Statistics and Research
Agency 2008
5
Trends in death rate

• Death rates in UK since early 1970s in last 10
  years
• 40 fall in CVD death rates for people under 75
  years
• 45 fall in CHD death rates for people under 65
  years
• CHD death rates falling slower in younger age
  groups and faster in higher age groups 1997 to
  2006
• 46 fall CHD in death rate for men aged 55-64
  years versus 22 fall in men aged 35-44 years
• 55 fall CHD in death rate for women aged 55-64
  years versus 20 fall in women aged 35-44 years

England and Wales Office for National Statistics
2008 Scotland, General Register Office
2008 Northern Ireland, Statistics and Research
Agency 2008
6
UK 1984-2004 Decline in overall age-adjusted CHD
mortality rate
2.7 per year (rate of decline)
3.7
5.4
men
1.7
3.5
women
4.2
7
Despite improvements, internationally, UK CHD
death rate relatively high
8
Changes in CHD death rates in selected countries
9
Standardised mortality ratio for CHD by sex
country of birth, 1989/92, England Wales
SMR
www.heartstats.org
Wild S, McKeigue P (1997)
10
Morbidity

• Incidence of MI
• Estimated 146 000 MIs every year (87 000 men / 59
  000 women) from 2006 CHD mortality data
• Prevelance MI
• Estimated that for all people over 35 years there
  are about 1.4 million people living who have had
  a MI (970 000 men / 439 000 women)
• Prevelance CHD (angina or MI)
• Estimated that for all people over 35 years there
  are about 5 million people living who have angina

England and Wales Office for National Statistics
2008 Scotland, General Register Office
2008 Northern Ireland, Statistics and Research
Agency 2008
11
Comment

• In spite of evidence that mortality from CVD is
  falling, morbidity appears to be rising
• CVD has significant cost implications in UK and
  is estimated to cost the NHS almost 14 750
  million in 2003 and the economy 30 billion year

12
Risk Factors
Age and gender main non-modifiable determinants
of CVD
Health Survey for England 2003
13
Smoking, cholesterol level and BP major
modifiable risk factors of CVD Relative odds of
major CHD within 10 years by usual serum total
cholesterol (left) and usual diastolic blood
pressure (right)adjusted for age and smoking
status
Emberson et al Eur Heart J 2003