• Overview
• Definition
• Incidence, prevalence and trends
• Risk factors
• Health consequences
• Costs
• Contributors

Incidence, Prevalence and Trends

Key messages

• Cardiovascular disease (CVD) accounts for up to half of all deaths in industrial countries. It causes about 200,000 deaths in the UK every year
• 30% of CVD deaths are premature, occurring before the age of 75. ¹
• The most recent prevalence estimates suggest that about 4 million people in the UK are living with the symptoms and limitations imposed by CVD. ²
• The biggest contribution to CVD comes from coronary heart disease (CHD), followed by stroke, then peripheral vascular disease (PVD). In the UK, these manifestations of atherothrombosis have been decreasing over recent decades.

Incidence

Each year the UK sees about 200,000 new cases of CHD, 100,000 of stroke and 50,000 of PVD. Most sudden cardiac deaths occur in the community, the majority of surviving CVD patients are then admitted to hospital (see Table 1).

Table 1: Hospital Episode Statistics for the NHS in England 2005-2006

Data obtained from Reference ³ .

Prevalence

Approximately 3 million adults in the UK are affected by CHD, approximately 1 million by stroke and 500,000 by PVD.

The mortality, incidence and prevalence rates increase steeply with age, approximately doubling with each decade. CVD is thus rare below 30, but increasingly common above the age of 60. ^{4 5}

Trends

In the UK CHD , ischaemic and hemorrhagic stroke have all declined substantially since 1970s. In fact, age-adjusted CHD mortality rates halved between 1980 and 2004. Approximately 60% of that reduction was attributable to decreases in population levels of the major risk factors, especially smoking, but also cholesterol and blood pressure. Some 40% of the reduction was attributable to medical treatments. Revascularisation (coronary artery bypass graft (CABG) surgery and angioplasty) accounted for less than 5% of the total reduction. Similar trends have been observed in most other industrialized countries. ⁶

Conversely, in developing countries age-adjusted CHD death rates are rapidly increasing. ⁷ In China, for instance, mortality rates rose by about 50% in men between 1980 and 1999. Most of this rise was attributable to large increases in total cholesterol and diabetes, reflecting a dramatic and rapid Westernisation of the previous (healthy) traditional Chinese diet. ⁸ Similar trends are occurring in most other developing countries. ⁹

Socio-economic patterns

Premature CVD (occurring before the age of 75 years) is 2-3 times more common in the most deprived groups. This reflects higher rates of smoking, worse diet and other factors. Above age 75, CVD social gradients are small.

Ethnic factors

In the UK, CVD is 50-100% higher in South Asian groups than in white groups, but is less common in West Indian and Asiatic groups.