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Improvements seen in coronary heart disease rates offset by other cardiovascular conditions

A substantial drop in rates of coronary heart disease in the UK over the past two decades has largely been offset by rising rates of other cardiovascular conditions, research shows.

Analysis of data from 2000 to 2019 showed rates of coronary heart disease fell by about 30%, with this improvement largely seen in the over 60s.

The study, which looked at 1.6 million individuals diagnosed with one of 10 cardiovascular-related conditions including atrial fibrillation and acute coronary syndromes, showed an overall drop of 19% over the period.

But, in parallel, there were increasing diagnoses of arrhythmias, valve disease and thromboembolic diseases, the researchers reported in the BMJ.

As a result, overall rates of CVDs across the 10 conditions remained relatively stable from the mid-2000s and trends were generally similar between men and women. 

The researchers also noted that where improvement was identified, this was not reflected in younger age groups and a socioeconomic gradient was also seen for almost every cardiovascular disease considered. 

The gradient did not decrease over time and was most noticeable for peripheral artery disease, which was almost twice as high in the most deprived group, and acute coronary syndrome and heart failure, which were both around 50% higher in the most deprived group.

Modestly higher rates of all 10 conditions were also seen in the North West, North East, Yorkshire and The Humber compared with London, even after adjusting for socioeconomic status.

Improvements in prevention of cardiovascular disease seen since the 1970s as a result of anti-smoking measures and more widespread use of drugs such as statins do now seem to have stalled in several high income countries, the researchers noted.

They concluded: ‘Despite substantial improvements in the prevention of atherosclerotic diseases in the UK, the overall burden of CVDs remained high during 2000 to 2019.

‘For CVDs to decrease further, future prevention strategies might need to consider a broader spectrum of conditions, including arrhythmias, valve diseases and thromboembolism, and examine the specific needs of younger age groups and socioeconomically deprived populations.’

Dr Sonya Babu-Narayan, associate medical director at the British Heart Foundation and consultant cardiologist, said: ‘We know that by 2019, decades of progress to save the lives of people with heart conditions had stalled.

‘And now, in the wake of a pandemic, things have only got worse. This study makes clear that many different types of cardiovascular condition need to be addressed if we are to reignite progress towards reducing the impact of cardiovascular disease.

‘The link between heart health and wealth is well-established. Cardiovascular disease kills one in four people in the UK so it’s vital that prevention, early diagnosis, treatment and care reaches those who need it, when they need it, wherever they live.’

A version of this article was originally published by our sister publication Pulse.