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Coronary heart disease (Cardiovascular disease)

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Cardiovascular disease is the UK’s top killer “ causing around 238,000 deaths a year. It is, however, a largely preventable disease and the main risk factors for it include smoking, obesity, a physically inactive lifestyle, poor diet, too much salt, alcohol, diabetes and raised blood pressure.

It is a high priority for the government, which published a National Service Framework (NSF) for Coronary Heart Disease (CHD) in 2000 to tackle the issue. It also appointed Dr Roger Boyle as the Œheart tsarà or national clinical director for heart disease.

That plan is aimed to modernise CHD services over 10 years and improve prevention, diagnosis, treatment and rehabilitation of this disease. One of its main targets was to cut CHD and stroke by 40% by 2010.

Various ways of doing that are set out in the NSF, including:
- Smoking cessation clinics set up in the community to help thousands of smokers to quit
- Nurses and family doctors in primary care creating registers of at risk patients and ensuring there is better drugs prescribing of aspirin, beta blockers and statins
- Faster access to treatment for people suffering heart problems with hundreds of defibrillators being made available in public places to help heart attack victims
- Ambulance response times speeded up for urgent cases
- Clot-busting (thrombolysis) drugs being made available within one hour of a heart attack victim calling for help
- More heart operations and waiting times for heart surgery being cut

The effort is paying off and an update report on the NSF from the Department of Health published half way through its 10 year programme in 2005 said there had been significant improvement in the management and prevention of cardiovascular disease.

Numbers of people smoking has fallen and there has been a 27% fall since 1996 in the death rate from heart disease, stroke and related diseases.

Nurses play an important part in preventing CHD as they take the lead in both systematic and opportunistic risk assessment of the disease. By giving good lifestyle advice, nurses can help people remain fit, reduce their blood pressure and prevent the need for drug therapy in some people with mild hypertension.

Campaigns such as the National School Fruit Scheme and Œ5 A DAYà (portions of fruit and vegetables) have also helped to promote a healthier diet in the population to tackle heart disease.

The National Institute for Health and Clinical Excellence (NICE) is developing guidance on cardiovascular risk assessment expected to be published in 2007.

Updated: September 2006

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