Better Health For All

Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels usually associated with a build-up of fatty deposits inside the arteries and an increased risk of blood clots. It has led to over a quarter of deaths in the UK and affects around 7 million people. Risk factors include smoking, obesity, mental illness, physical inactivity, and long term factors like diabetes, high cholesterol and high blood pressure. These can all be addressed with the right care and support.

The National Institute for Health and Care Excellence (NICE) has produced a number of impact reports which show how the recommendations that NICE develop, are being used in health and social care services in the UK.

Data in the new NICE impact report on CVD prevention suggest NICE is having a positive impact in this area, but the report also shows that our recommendations need to be applied more consistently to provide better advice to prevent CVD and reduce the number of associated deaths.

For example, data from one report, shows that in 2016, the number of adults who smoked fell to 15.5% of the population. To encourage people to stop smoking, we recommend offering patients in hospitals, mental health and maternity services advice on quitting But it has been shown that of the 73% that had their smoking status recorded only 28% were asked if they would like to quit, which suggests key opportunities are being missed to further tackle smoking rates. Data also shows that more could be done to implement NICE’s recommendations in schools with 40% of pupils not receiving the right level of education on the risks of tobacco use, as advised by NICE.

The impact report also looks at some of the major causes of CVD including high blood pressure, high cholesterol and diabetes. Diagnosing and managing these conditions is important to preventing CVD events like heart attacks, where the blood flow to the heart muscle is suddenly blocked, and strokes, where the blood supply to part of the brain is cut off, which can cause brain damage and possibly death. NICE is working with other organisations to include our guidance in the CVD Prevention Pathway, which aims to give NHS Trusts the tools and resources to detect and treat these conditions in local services.

For high blood pressure, data shows that just 60% of people under 80 achieved the NICE recommended target blood pressure. Our guidance on high blood pressure highlights the importance of physical activity, in managing those with this condition. However, data shows only 9% of people with high blood pressure aged 16-74 had their physical activity assessed in the last 12 months. This indicates that we are not doing enough to encourage people to exercise more, and thus to reduce risk of CVD.

Our latest impact report shows the positive effect NICE is having on CVD prevention across the health and care system. But there is a familiar pattern of potential missed opportunities to improve patient care and save lives. We know only too well the challenges the system faces to deliver high quality care. When the evidence shows that using NICE guidance works, we need to make sure it is at the heart of local strategies to reduce premature deaths from CVD and preventable illness.

Written by Professor Gillian Leng, Deputy Chief Executive and Director Health and Social Care, NICE