The NHS and Public Health England (PHE) have announced a new initiative to prevent heart attacks and strokes, saving thousands of lives by taking a more integrated approach to cardiovascular care.

New PHE analysis suggests that there is now an opportunity to prevent more than 9,000 heart attacks and at least 14,000 strokes over the next 3 years with better detection and management of:

  • high blood pressure
  • high cholesterol
  • atrial fibrillation (AF)

Sir Bruce Keogh, the National Medical Director of NHS England said: “Closer working between NHS organisations and local authorities will create new opportunities to get serious about prevention and bear down on 2 of the biggest killers, between them responsible for 1 in 4 premature deaths.

“Cardiovascular disease kills more people in this country than anything else,” said the former heart surgeon.

“We know how to treat the resulting heart attacks and stroke, but everyone knows that prevention is better than cure. Prevention of these devastating consequences is everybody’s business from our schools, to the food and tobacco industries, to local authorities and the NHS.”

Some 5.5 million people in England have undiagnosed high blood pressure and nearly half a million have undiagnosed AF, which are both usually symptomless conditions that substantially increase the risk of stroke, heart attack, dementia and limb amputations. Treatment is effective at reducing risk but under treatment is common among those who are diagnosed.

The new analysis shows the scale of the prevention opportunity across England over 3 years if treatment of these high-risk conditions is optimised. Achieving optimal treatment in all people with diagnosed high blood pressure has the potential to avert up to 9,710 heart attacks and 14,500 strokes, saving up to £274 million. Achieving optimal treatment for those diagnosed with AF has the potential to avert up to 14,220 strokes, saving £241 million.

Duncan Selbie, Chief Executive of PHE, said: “High blood pressure is the invisible killer. We want people to be as familiar with their blood pressure numbers as they are with their credit card PIN or their height.

“Too many people are still living in poor health and dying from a largely preventable disease. The good news is that we know how most heart attacks and strokes can be avoided. Scaling up CVD prevention locally is a major part of reducing the overall burden on individuals, families and the NHS, and will help to ensure a person’s health is not defined by where they live.”

PHE and NHS England have today written to all 44 STPs, drawing attention to the prevention opportunity, and sharing with them the data for their local area.

By working across larger populations, STPs can mobilise clinical leaders across a geography and drive larger-scale improvements such as increasing access to blood pressure testing in the workplace, and using the wider local authority and third sector workforce to carry out health checks in community settings.

The majority of STPs have identified prevention of CVD as a priority. They are likely to drive improvements in 2 ways. Firstly through partnerships that support widespread implementation of initiatives such as healthy workforce schemes, active transport plans, the Active 10 app, and smoking cessation programmes. Secondly, they have the ability to roll out the NHS Right Care CVD Prevention Programme across a much wider area.

The NHS Right Care programme will help GPs and local areas to ensure more patients get proven treatments by organising local services differently. This will include more testing and treatment in pharmacies, increasing uptake of NHS Health Check, more self-monitoring, more access to blood pressure testing in community and workplace settings, and new digital tools such as the One You Heart Age Test.

The NHS Health Check is offered to all eligible people between 40 and 74 every 5 years. As well as supporting people to reduce lifestyle risk factors, it provides a systematic way of identifying people with undiagnosed high-risk conditions like high blood pressure and AF. But currently only a half all eligible people take up the offer.