Cardiovascular disease

Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels. It's usually associated with a build-up of fatty deposits inside the arteries (atherosclerosis) and an increased risk of blood clots.

It can also be associated with damage to arteries in organs such as the brain, heart, kidneys and eyes. CVD is one of the main causes of death and disability in the UK, but it can often largely be prevented by leading a healthy lifestyle.

NHS Long Term Plan

The NHS Long Term Plan identifies cardiovascular disease as a clinical priority and the single biggest condition where lives can be saved by the NHS over the next 10 years.

The Plan sets the ambition for the NHS to help prevent over 150,000 heart attacks, strokes and dementia cases over the next 10 years and outlines how we, and partners in the voluntary and community sector and in other national organisations will meet this ambition.

National Stroke Service Model

Stroke prevention is achieved primarily in the community: targeting both the highrisk general population (primary prevention) including those specifically at higher risk through social inequalities, and those discharged following a stroke or transient ischaemic attack (TIA) (secondary prevention). It is however the responsibility of the ISDN and all healthcare practitioners involved in stroke care to ensure that secondary prevention is considered, risk factors screened for and patients offered intervention at every opportunity and with regular follow-up.

There should be a focus on communication with patients, their relatives or carers, GPs, and others involved in their care, to ensure patient ownership of decisions relating to them. Patients’ differing health beliefs and needs should be clearly acknowledged, with particular attention paid to seldom heard groups and those with communication difficulties. Patient understanding of, and adherence to, prevention should be everyone’s responsibility.

Key risk factors for stroke, including hypertension, hypercholesterolaemia, atrial fibrillation (AF), poor diet, obesity, smoking and lack of physical exercise. The use of innovative strategies and technologies should be encouraged to detect and address physical and social economic risk factors for stroke, and the impact of health inequalities and digital inequalities recognised when managing high risk groups. What do local stroke systems need to do? Working with local primary care networks (PCNs), ISDNs should:

  • support the introduction of the National Primary Care Audit, and respond to SSNAP indicator F6 (unmedicated known AF);
  • support the implementation of the community pharmacy contract and involve local voluntary sector partners to provide the public with readily accessible screening for hypertension, particularly those from deprived and disadvantaged groups;
  • ensure that primary and secondary care teams are adhering to the 140/90 blood pressure NICE guidance6 ;
  • be aware of PCN test-bed programmes to increase diagnosis and detection of highrisk conditions;
  • work with community pharmacists, GP practices and voluntary sector partners such as the British Heart Foundation and the Stroke Association to raise awareness of stroke and its symptoms, and risk prevention;
  • support uptake of the NHS Health Check and work on risk factor management, eg smoking, weight and alcohol services, and;
  • support delivery of the NHS Long Term Plan and Public Health England CVD ambitions around the three high-risk conditions – AF, high blood pressure and high cholesterol.