Coronary heart disease statistics 2010 edition Peter Scarborough, Prachi Bhatnagar, Kremlin Wickramasinghe, Kate Smolina, Colin Mitchell and Mike Rayner British Heart Foundation Health Promotion Research Group Department of Public Health, University of Oxford British Heart Foundation Statistics Database www.heartstats.org 1 Contents Page Foreword 7 Introduction 8 Summary 9 Glossary 11 Chapter 1 Mortality 14 Targets Table/Figure CVD mortality targets Table 1.1 17 Tracking English CVD target Figure 1.1a 18 Tracking English CVD inequalities target Figure 1.1b 18 Tracking Scottish CHD target Figure 1.1c 19 Tracking Welsh CHD target Figure 1.1d 19 Tracking Welsh inequalities CHD target Figure 1.1e 20 Deaths by cause Numbers of deaths by age and sex, UK Table 1.2 21 Numbers of deaths by sex and country of the UK Table 1.3 22 Male deaths by cause, all ages Figure 1.3a 23 Female deaths by cause, all ages Figure 1.3b 23 Male deaths by cause, under 75 Figure 1.3c 24 Female deaths by cause, under 75 Figure 1.3d 24 Excess winter mortality Excess winter CVD mortality, England and Wales Table 1.4 25 Time and geographical trends Age-specific CHD time trends, UK Table 1.5, Figure 1.5a, b 26-27 CHD time trends, by Government Office Region Table 1.6 28 Premature CHD death rates, by local authority Table 1.7, Figure 1.7a,b 29-35 Socio-economic differences CVD, CHD, stroke by socioeconomic status, England and Wales Table 1.8 36 CHD by socioeconomic status, England and Wales Figure 1.8 36 British Heart CHD by deprivation quintile, Great Britain Table 1.9, Figure 1.9a,b 37-38 Foundation Statistics Database www.heartstats.org 2 International differences Time trends in CHD death rates, Europe Table 1.10a,b 39-40 CHD death rates, selected European countries Figure 1.10a 41 Changes in CHD deaths rates over 10 years, selected European countries Figure 1.10b 41 Chapter 2 Morbidity 42 Incidence Myocardial infarction, England and Scotland Table 2.1, Figure 2.1 46 Stroke, England and Scotland Table 2.2, Figure 2.2 47 Angina, UK Table 2.3 48 Heart Failure, UK Table 2.4 48 Case-fatality Myocardial infarction, England and Scotland Table 2.5 49 Stroke, England and Scotland Table 2.6 49 Prevalence CHD, stroke, myocardial infarction, angina, England Table 2.7 50 CHD, stroke, myocardial infarction, angina, Scotland Table 2.8 50 Any heart condition, stroke, myocardial infarction, angina, heart failure, Wales Table 2.9 51 Stroke, myocardial infarction, angina, Northern Ireland Table 2.10 51 Myocardial infarction, stroke, angina, UK Figure 2.10a,b,c 52-53 Angina, UK Table 2.11 54 Heart failure, UK Table 2.12 54 CHD, stroke, hypertension by health authority, UK Table 2.13 55 CVD over time, by age and sex, Great Britain Table 2.14, Figure 2.14 56-57 Chapter 3 Treatment 58 Prescriptions for CVD Time trends, England Table 3.1, Figure 3.1 62-63 Revascularisations Time trends in CABGs, PCIs, UK Table 3.2, Figure 3.2 64 Inpatient episodes Main diagnosis, England and Scotland Table 3.3 65 Main diagnosis, England Figure 3.3a,b 66 Main diagnosis, Scotland Figure 3.3c,d 67 British Heart Foundation Statistics Database www.heartstats.org 3 Hospital discharges Time trends in hospital discharges for CVD, Europe Table 3.4 68 Time trends in hospital discharges for CHD, Europe Table 3.5, Figure 3.5 69-70 Time trends in hospital discharges for stroke, Europe Table 3.6, Figure 3.6 71-72 Smoking cessation Time trends in use of nicotine replacement therapy, England, Scotland and Northern Ireland Table 3.7 73 Ambulance services Time trends in responses to emergency calls within eight minutes, England Table 3.8 74 Treatment after a heart attack Time trends in thrombolytic treatment and use of secondary prevention medication, England and Wales Table 3.9 74 Chapter 4 Behavioural risk factors 75 Smoking Time trends in smoking prevalence, Great Britain Table 4.1, Figure 4.1 80-81 Time trends in smoking prevalence, Northern Ireland Table 4.2 82 Prevalence by region, UK Table 4.3 83 Prevalence by socioeconomic status, Great Britain and Northern Ireland Table 4.4, Figure 4.4a,b 84-85 Prevalence by ethnic group, England Table 4.5 86 Time trends in prevalence of smoking in young people, England, Scotland, Wales, Northern Ireland Table 4.6 87 Prevalence of tobacco use, the World Table 4.7 88 Diet Time trends in consumption of fat, salt, sugar, fibre, fruit and vegetables, Great Britain Table 4.8 89 Time trends in consumption of selected foods, UK Table 4.9, Figure 4.9,a,b,c 90-92 Quality of diet, UK Table 4.10 93 Consumption of salt, Great Britain Table 4.11 93 Consumption of fat, salt, sugar, fibre, fruit and vegetables, by Government Office Region Table 4.12 94 Consumption of fat, salt, sugar, fibre, fruit and vegetables, by income quintile, UK Table 4.13 95 Consumption of fat, salt, sugar, fibre, fruit and vegetables, by ethnic group, UK Table 4.14 96 Consumption of fruit and vegetables in children, England Table 4.15 97 British Heart Total energy available from fat and availability of fruit Foundation and vegetables, Europe Table 4.16 98 Statistics Database www.heartstats.org 4 Physical inactivity Trends in prevalence, England, Scotland, Wales Table 4.17 98 Prevalence, England, Scotland, Wales and Northern Ireland Table 4.18 99 Prevalence by strategic health authority, England Table 4.19 100 Prevalence by income quintile, England Table 4.20, Figure 4.20 101 Prevalence by ethnic group, England Table 4.21 102 Time trends in children’s physical activity levels, England Table 4.22 102 Prevalence by country, European Union Table 4.23, Figure 4.23 103-104 Alcohol Consumption by sex and age, Great Britain Table 4.24, Figure 4.24 105 Time trends in heavy drinking, Great Britain Table 4.25, Figure 4.25 106-107 Time trends in consumption by children, England Table 4.26 108 Time trends in consumption by children, Scotland Table 4.27 109 Heavy drinking by country or region, Great Britain Table 4.28, Figure 4.28a,b 110-111 Consumption by socioeconomic status, Great Britain Table 4.29, Figure 4.29 112-113 Consumption by ethnic group, England Table 4.30 114 Frequency of heavy drinking by country, European Union Table 4.31, Figure 4.31 114-115 Chapter 5 Medical risk factors 116 Blood pressure Definition and recommendation for treatment Table 5.1 123 Time trends in prevalence of hypertension, England Table 5.2, Figure 5.2a,b 124-125 Blood pressure levels, England Table 5.3, Figure 5.3 126 Blood pressure levels, Scotland Table 5.4 127 Prevalence of hypertension, Wales Table 5.5 127 Blood pressure levels by Government Office Region, England Table 5.6 128 Blood pressure levels by income, England Table 5.7 128 Blood pressure levels by ethnic group, England Table 5.8 129 Prevalence of hypertension by country, Europe Table 5.9 129 Cholesterol Recommendations and target Table 5.10 131 Time trends in cholesterol levels, England Table 5.11, Figure 5.11 132 Prevalence of low HDL-cholesterol, England Table 5.12 133 Prevalence of total cholesterol and low HDL-cholesterol by region, England and Scotland Table 5.13 133 Prevalence of total cholesterol and low HDL-cholesterol by income, England Table 5.14 134 Prevalence of total cholesterol and low HDL-cholesterol by ethnic group, England Table 5.15 134 British Heart Foundation Statistics Database www.heartstats.org 5 Obesity Targets, UK Table 5.16 135 BMI by sex and age, England Table 5.17, Figure 5.17 136 Prevalence of raised waist circumference, England Table 5.18 137 Overweight and obesity in children, England Table 5.19 137 Underweight, healthy weight, overweight and obese school children, England Table 5.20 138 Time trends in prevalence of obesity, England Table 5.21, Figure 5.21 139 Time trends in prevalence of overweight and obesity in children, England and Scotland Table 5.22, Figure 5.22 140 BMI by Government Office Region, England Table 5.23 141 BMI by income, England Table 5.24 141 Raised waist circumference by income, England Table 5.25 142 BMI, waist-hip ratio and waist circumference by ethnic group, England Table 5.26, Figure 5.26a,b 142-143 Prevalence of overweight and obese children, the World Table 5.27 144 Diabetes Prevalence of diagnosed diabetes, England Table 5.28 145 Prevalence of diagnosed diabetes, Scotland Table 5.29 145 Prevalence of diagnosed diabetes, Wales Table 5.30 145 Prevalence of diagnosed diabetes, Northern Ireland Table 5.31 146 Time trends in the prevalence of diagnosed diabetes, country of the UK Table 5.32, Figure 5.32a,b 146-147 Prevalence of diagnosed diabetes by Government Office Region, England Table 5.33 148 Prevalence of diagnosed diabetes by income, England Table 5.34 148 Prevalence of diagnosed diabetes by ethnic group, England Table 5.35, Figure 5.35 149 Prevalence of diabetes by country, Europe Table 5.36 150 Chapter 6 Economic costs 151 Health care costs CHD, CVD, stroke, UK Table 6.1, Figure 6.1a,b,c 153-154 Total costs CHD, CVD, stroke, UK Table 6.2 155 International differences in costs CHD, CVD, stroke by EU country, Europe Table 6.3 156 British Heart Foundation Statistics Database www.heartstats.org 6 Foreword This new edition of Coronary Heart Disease Statistics documents areas in the fight against coronary heart disease in which we have come a long way, where we still have a long way to go, and where we have barely made an impact.