Prevention of cardiovascular disease

Overview

Health policy is devolved. This information applies to England.

What is cardiovascular disease?

The cardiovascular system (sometimes referred to as the ‘circulatory system’) controls the flow of blood around the body to organs and tissues. Cardiovascular disease (CVD) (sometimes referred to as heart and circulatory diseases) is a general term for conditions affecting the functioning of the heart and blood vessels and which make it harder for blood to flow freely through the body. CVD is typically associated with the build-up of fatty substances in the arteries over time, causing them to narrow and disrupt the flow of blood, a process known as atherosclerosis. It can also be associated with damage to arteries in organs such as the brain, heart, kidneys and eyes.

Examples of CVD include:

• coronary heart disease, when there is reduced or blocked flow of blood to the heart
• stroke, when blood supply to part of the brain is cut off
• peripheral arterial disease, when arteries to the limbs are blocked
• aortic disease, a group of conditions affecting the blood vessel that carries blood from the heart to the rest of the body

A British Heart Foundation factsheet published in January 2025 (PDF) notes that CVD may be inherited or may develop later in life. It estimates that there are more than 6.4 million people living with a CVD in England (page 3).

The NHS identifies risk factors for CVD, including:

• High blood pressure
• Smoking
• High cholesterol
• Diabetes
• Kidney disease
• Inactivity
• Being overweight or obese.

Those with a family history of CVD, and “people of south Asian and Black African or African Caribbean background”, are also identified by the NHS as at increased risk of developing CVD.

Premature deaths

NHS England reports that CVD is responsible for “one in four premature deaths” in the UK (a death that occurs in people aged under 75 years).

The premature mortality rate from CVD in England fell from 145.2 premature deaths per 100,000 population in 2001 to 69.1 per 100,000 population in 2019. Since then it has risen slightly, to 77.4 per 100,000 population in 2023. This is approximately equivalent to the rate in 2012.

There is a socio-economic gradient to those premature deaths. Those in the most deprived 10% of the population in England were, in 2023, twice as likely to die prematurely from CVD than those in the least deprived 10% of the population.

Men are twice as likely to die prematurely from CVD as women in England. This gap has remained largely consistent for the last decade.

The premature mortality rate from CVD in 2023 was highest in the North West region (93.8 per 100,000), the North East region (88.2) and the Yorkshire and the Humber region (88.1). The rate was lowest in the South East region (62.1) and the South West (68.6).

You can view trends for England and for local authorities on the Office for Health Improvement and Disparities Fingertips data website.

Government activity Darzi report

In July 2024, Wes Streeting, Secretary of State for Health and Social Care, commissioned Lord Darzi to carry out an independent investigation into the NHS in England. The final report of the investigation (‘the Darzi report’) was published in September 2024. Lord Darzi ultimately concluded that the NHS is in “serious trouble” (page 1). Regarding CVD, the report said “care for cardiovascular conditions is going in the wrong direction” and that “rapid access to treatment had deteriorated” (page 5).

10-year health plan

The government said it will publish a 10-year health plan in spring 2025 to “reform” healthcare by shifting from “hospital to community” care, rolling out new technologies, and focusing on preventing illnesses by identifying and managing issues earlier. It says these shifts will help to reduce lives lost to CVD.

NHS Health Checks and diagnostics

The NHS Health Check programme aims to prevent heart disease, stroke, type 2 diabetes and kidney disease, and some cases of dementia among adults aged between 40 and 74 years old. The government has said it is developing a digital NHS Health Check, which will be ready for testing in early 2025 and would enable people to take a health check at home. It also said it is trialling heart health checks for people in workplaces to improve earlier diagnosis of CVD.

2019 Long Term Plan

There is information on the NHS England website about CVD, including ongoing work to address it. Much of this relates to the 2019 NHS Long Term Plan ambitions to help prevent CVD (see Long Term Plan 2019, CVD). The 2019 Long Term Plan sets out actions that aim to help prevent up to 150,000 heart attacks, strokes, and dementia cases by 2029, and the government has said progress towards this is ongoing. A CVD programme has been established led by national clinical directors and national speciality advisors and supported by advisory groups with cardiac and stroke speciality clinicians.

Major conditions strategy

The previous Conservative government intended to publish a major conditions strategy, which would cover six conditions including cardiovascular disease. In August 2023, the government published the Major Conditions Strategy: case for change and our strategic framework. The development of this strategy was paused following the general election.

Stakeholder commentary

In November 2024, the National Audit Office, the UKs independent public spending watchdog published a report titled “Progress in preventing cardiovascular disease”. The report concluded “there is currently no effective system for commissioning Health Checks” and there were “weak levers” for healthcare services to deliver health checks (page 3). The report recommended the Department of Health and Social Care:

• review the value of the current way Health Checks are commissioned
• set clear targets on the proportion of eligible populations who should attend Health Checks
• incentivise delivering Health Checks to those at highest risk of CVD
• alongside NHS England, assess the feasibility of adding Health Check data to CVDPREVENT (a national audit of health records to help primary care providers to understand diagnosis and treatment of CVD)

The British Heart Foundation has recommended the government to “commit to a heart disease action plan”.

Parliamentary materials

Progress in preventing cardiovascular disease - Oral evidence

22 January 2025 | Health and Social Care Committee

Cardiovascular diseases: Research

UIN 11674 | 11 November 2024

Asked by: Sonia Kumar

To ask the Secretary of State for Health and Social Care, whether his Department is taking steps to commission research into new cardiovascular treatments.

Answering member: Andrew Gwynne | Department of Health and Social Care

The Government, through the National Institute of Health and Care Research (NIHR) is committed to funding high quality, timely research that leads to improved outcomes for patients and the public and makes the health and social care system more efficient, effective, and safe. Research evidence is vital for improving treatments and outcomes for people, including those with cardiovascular disease.

The Department is proud to invest £1.5 billion per year on health research through the National Institute for Health and Care Research. Over the past five financial years between 2019/20 and 2023/24, the NIHR has invested £145.4 million on cardiovascular disease and stroke research directly through NIHR research programmes. Our wider investments in NIHR infrastructure, including strengthening specialist facilities, workforce, and support services to enable research in the health and care system, have enabled significant cardiovascular disease (CVD) and stroke research funded by other funders to take place.

The NIHR welcomes funding applications for research into any aspect of human health, including CVD. As with other Government funders of health research, the NIHR does not allocate funding for specific disease areas.

Cardiovascular Diseases: Death

UIN 8170 | 14 October 2024

Asked by: Rachael Maskell

To ask the Secretary of State for Health and Social Care, What progress his department has made on reducing deaths from stroke and heart disease by a quarter within ten years.

Answering member: Andrew Gwynne | Department of Health and Social Care

Reducing avoidable disability and death from heart disease and stroke is a priority for the Government. This is why the Government has set a goal for fewer lives being lost to the biggest killers, including from cardiovascular disease (CVD), and why the NHS England's Long Term Plan (2019) sets out a number of actions that aim to help prevent up to 150,000 heart attacks, strokes, and dementia cases by 2029.

The Government continues to support the delivery of the NHS Health Check programme, England’s CVD prevention programme, to people aged 40 to 74 years old. This programme identifies people at risk of CVD, supports people in reducing their risk, and prevents approximately 400 heart attacks or strokes each year. To improve access and engagement with the life-saving programme, we are developing a digital NHS Health Check which will be ready for testing in early 2025 and will enable people to undertake a check at home. We are also trialling the delivery of heart health checks to over 130,000 people in workplaces across the country.

Community pharmacies also provide a free blood pressure check service for anyone over 40 years old. In cases where this results in a high reading, pharmacists can make sure people receive the right National Health Service support to reduce their blood pressure and risk of death or serious disability.

We know there is more to do. The Department and NHS England are working together to achieve the Government’s ambition for fewer lives lost to the biggest killers, including CVD, and we will share more in due course.

Further reading Stakeholder material

• National Institute for Health and Care Excellence, What is the impact of CVD?, September 2024
• British Heart Foundation, New Government must commit to a heart disease action plan, 5 July 2024
• The King’s Fund, Cardiovascular disease in England, 11 November 2022
• Nuffield Trust, Care for heart attack patients, 24 February 2022
• British Heart Foundation, Excess deaths involving cardiovascular disease: an analysis
• British Heart Foundation, Heart Statistics

Press releases

• National Audit Office, Progress in preventing cardiovascular disease, 13 November 2024
• Department of Health and Social Care, Government to consider radical new approach to prevent life-threatening cardiovascular disease, 7 March 2023
• NHS England, Cardiovascular disease (CVD) prevention recovery: how the NHS is working to restore diagnosis and management of cardiovascular disease, 8 June 2022
• Office for Health Improvement and Disparities, Cardiovascular disease prevention: applying All Our Health, 10 March 2022