Trends in the epidemiology of cardiovascular disease in the UK

Abstract

Cardiovascular disease (CVD) mortality in the UK is declining; however, CVD burden comes not only from deaths, but also from those living with the disease. This review uses national datasets with multiple years of data to present secular trends in mortality, morbidity, and treatment for all CVD and specific subtypes within the UK. We produced all-ages and premature age-standardised mortality rates by gender, standardised to the 2013 European Standard Population, using data from the national statistics agencies of the UK. We obtained data on hospital admissions from the National Health Service records, using the main diagnosis. Prevalence data come from the Quality and Outcome Framework and national surveys. Total CVD mortality declined by 68% between 1980 and 2013 in the UK. Similar decreases were seen for coronary heart disease and stroke. Coronary heart disease prevalence has remained constant at around 3% in England and 4% in Scotland, Wales, and Northern Ireland. Hospital admissions for all CVD increased by over 46 000 between 2010/2011 and 2013/2014, with more than 36 500 of these increased admissions for men. Hospital admission trends vary by country and CVD condition. CVD prescriptions and operations have increased over the last decade. CVD mortality has declined notably for both men and women while hospital admissions have increased. CVD prevalence shows little evidence of change. This review highlights that improvements in the burden of CVD have not occurred equally between the four constituent countries of the UK, or between men and women.

Keywords: Stroke.

Figure 1

Age-standardised death rates per 100 000 from cardiovascular disease, all ages, UK and England, Wales, Scotland, Northern Ireland, 1979–2013.

Figure 2

Age-standardised death rates per 100 000 from coronary heart disease, all ages, UK and England, Wales, Scotland, Northern Ireland, 1979–2013.

Figure 3

Age-standardised death rates per 100 000 from stroke, all ages, UK and England, Wales, Scotland, Northern Ireland, 1979–2013.

Figure 4

Trends in the prevalence of cardiovascular disease (CVD), coronary heart disease (CHD), and stroke, from the health surveys of England and Scotland 2003–2013.

Figure 5

Trends in the prevalence from cardiovascular diseases in men and women by age, from the General Lifestyle Survey, Great Britain 1988–2011.

Figure 6

Number of coronary artery bypass operations and percutaneous coronary interventions per year, UK 1980–2013.