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Coronary heart disease

Coronary heart disease (CHD) is defined as a condition where blood flow to the heart muscles is reduced or cut off, resulting in damage to the heart.  Risk factors that can be addressed include smoking, obesity, lack of physical activity, high blood pressure, diabetes and high cholesterol.  CHD is the one of England’s leading causes of death and is the leading cause of death worldwide; in 2018 there were around 52,000 deaths across England attributed to CHD.

Local prevalence remains higher than national figure

In Herefordshire in 2017/18 there were 6,587 patients listed on GP practice CHD registers, which corresponds to 3.5% of registered patients in the county. While the prevalence for England has fallen steadily since 2009/10 the local figure had shown little change and has remained consistently higher than that reported nationally over this period. Similarly, the prevalence of heart failure in Herefordshire has remained relatively constant since 2009/10 and has been consistently higher than the national figure (Figure 1).

Figure 1: Prevalence of CHD (solid lines) and heart failure (dotted lines)

Chart showing the trend in the prevalence of coronary heart disease and heart failure in Herefordshire and England 2009-10 to 2017-18.

Premature mortality rate continues to fall

The CHD related premature mortality rate (i.e. under 75 years) in Herefordshire has almost halved since 2003-05 mirroring the national pattern (Figure 2). In 2015-17 the local rate was 33.9 per 100,000, a figure similar to that observed across England as a whole.

Figure 2: Premature CHD mortality rate

Chart showing the trend in the premature CHD mortality rate in Herefordshire and in England between 2003-05 and 2015-17.

Admission rates lower than for England

In 2017/18 the admission rate for CHD in NHS Herefordshire CCG was 471 for every 100,000 people in the population (1,052 admissions) which is significantly lower than the England rate of 502 per 100,000. Similarly, the local admission rate for heart failure (120 per 100,000) was lower than that reported nationally (162 per 100,000).