Cardiovascular data shows areas of need

Primary care organisations (PCOs) need to use the latest GMS prevalence data on CHD, hypertension and stroke to tailor cardiovascular services for their local population, say experts.

The data could help identify which areas need to apply standards from the NSF for CHD, said Kent GP Dr Rubin Minhas, CHD lead for Medway PCT.

‘The key thing is that when national priorities are applied they need to be sensitive to local needs,’ said Dr Minhas.

Data from the quality framework 2005/6 shows that for all three disease areas Wales, Scotland and northeast England generally have the highest rates of prevalence.

For hypertension, more than a quarter of the population are affected in areas of highest prevalence compared with less than 10 per cent in southeast England, where prevalence is lowest.

In areas with the highest CHD prevalence, 8.5 per cent of practice populations are affected, compared with 2.2 per cent in low prevalence areas.

‘The correlation between CHD and deprivation is a strong one,’ said Dr Minhas. ‘More affluent areas have lower prevalence of CHD.’

RCGP vice-chairman Dr Graham Archard said people living in areas of low socioeconomic status are more likely to smoke and make unhealthy lifestyle choices.

The areas shown to have the highest prevalence on the latest maps are those that are known to be hit hardest by cardiovascular disease (CVD).

‘Prevalence of IHD has been known to be worse the more north you go,’ said Professor Mike Kirby, Hertfordshire GP and member of the Primary Care Cardiovascular Society. But the latest prevalence data indicates clearly the areas where health inequalities are affecting CHD, he added.

‘These figures are demonstrating areas of need and the PCOs do theoretically have capacity to input finances into (clinical) areas of high need.’

Professor Kirby said: ‘The highest risk of CHD, hypertension and stroke are associated to some extent with deprivation and the new SIGN CVD risk calculator has recognised the need to take in deprivation is part of an overall cardiovascular risk assessment.’

Under the latest guidelines issued by SIGN, a calculator that incorporates local postcodes will be used to assess all patients over 40 for cardiovascular risk.

Prevalence maps for hypertension and stroke show similar patterns, reflecting the role of high BP in stroke and shared risk factors, said Professor Kirby.

But CHD prevalence is different, reflecting the ‘multifactorial’ nature of the illness, he said.

‘These figures are helpful because they do allow us to use geographic mapping.’

PCOs should work with the Public Health Observatory to produce similar prevalence maps specific to their area, said Professor Kirby.

‘Within any one PCO they would be able to do this sort of mapping,’ he concluded.

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