Cheshire & Merseyside Cardiovascular Programme

Transcription

1 Cheshire & Merseyside Cardiovascular Programme CVD Prevention and lipids: Are we doing enough? POP-UP UNIVERSITY SESSION Date: Thursday 6 September - Time: 10:45-11:45 Dr Scott W Murray Consultant Cardiologist Royal Liverpool University Hospital President BACPR

2 The Causes of the Causes..

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6 Jamie Waterall National Lead for CVD Prevention and Associate Deputy Chief Nurse. Jamie will offer the national view on CVD prevention. Dr Iefoma Onyia Consultant in Public Health, Halton Borough Council. Ifeoma will share with us the work carried out in C&M, what the priorities have been and what is the local public health view. Dr Joe Mills Consultant Cardiologist, Clinical Lead C&M Cardiology Clinical Network. Joe will take us through the thinking and process to develop a new lipid pathway; what the expected impact and outcomes are.

7 Improving Pathways; Lipids and CVD: Are we doing enough? Professor Jamie Waterall National Lead for CVD Prevention & Associate Deputy Chief Nurse Public Health

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9 Age standardised mortality rates from leading causes of death2001 to 2015,

10 Burden of disease attributable to leading risk factors for both sexes, GBD 2016, expressed as a percentage of England disability-adjusted life-years GBD 2016 Tobacco Dietary risks High systolic blood pressure High body-mass index Alcohol and drug use High total cholesterol Occupational risks High fasting plasma glucose Air pollution Impaired kidney function Low physical activity Child and maternal malnutrition Low bone mineral density Unsafe sex Sexual abuse and violence Other environmental risks Unsafe water, sanitation, and HIV/AIDS and tuberculosis Diarrhea, lower respiratory, and other common infectious diseases Neglected tropical diseases and malaria Maternal disorders Neonatal disorders Nutritional deficiencies Other communicable, maternal, neonatal, and nutritional diseases Neoplasms Cardiovascular diseases Chronic respiratory diseases Cirrhosis and other chronic liver diseases Digestive diseases Neurological disorders Mental and substance use disorders Diabetes, urogenital, blood, and endocrine diseases Musculoskeletal disorders Other non-communicable diseases Transport injuries Unintentional injuries Self-harm and interpersonal violence Forces of nature, conflict and terrorism, and executions and police conflict 0% 1% 2% 3% 4% 5% 6% 7% 8% 9% 10% 11% 12% Percent of total disability-adjusted life-years

11 11 For every 1mmol/L decrease in total cholesterol people can reduce their relative risk for CVD related mortality by 24.5% & by 29.5% for any CVD event

12 High risk conditions for CVD Rule of halves High Blood Pressure Every 10mmHg reduction lowers risk of CVD event by 20% Detected 6 in 10 Controlled 6 in10 to 140/90 Atrial Fibrillation Anticoagulation lowers risk of stroke by 2/3 Known AF and on anticoagulant 1 in 2 at time of stroke High Cholesterol Every 1 mmol/l reduction lowers risk of CVD event by 25% each year 10 year CVD risk above 20% 1 in 3 and on statins

13 Building strong system leadership to improve CVD outcomes across England There will be three new priority areas which were not a focus in the Five Year Forward View. One of these is a new focus around cardiovascular disease stroke and heart attacks. Mr Stevens said there was growing evidence the NHS had ground to catch up.

14 Heart Age Test Getting Serious About CVD Prevention 14

15 Almost 7 million people have received an NHS Health Check over the past 5 years

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17 Bradford s Health Hearts Programme Getting Serious About CVD Prevention

18 Getting Serious About CVD

19 The Cheshire and Merseyside Population Perspective Dr Ifeoma Onyia Public Health Consultant Halton Borough Council

20 Problem Potentially 9600 affected individuals Multiple organisational partners No pathway Lack of cascade testing services/access to DNA clinics No systematic testing in general public Unclear role for lifestyle services Reliance on NHS Health Checks Limited knowledge of the issue within the system

21 Solutions Partnerships linked by CHAMPS; STP CVD Programme Board Pathway for Dyslipidaemia and Familial Hypercholesterolaemia adds clarity to increase case finding, cascade testing and medication Access to specialist clinics and paediatric support is planned CVD Prevention website (working with NHS RightCare) raising staff and public awareness Wide scale MECC programme - lifestyle advice at every opportunity

22 Ongoing Challenges Wider awareness of FH and raised lipids as a potential area for action Low reach of current approach especially <10 yr olds Lack of consistency and specificity in lifestyle advice Poor data how will we know if we are successful? Funding