Official Statistics

Cardiovascular disease profiles: short statistical commentary

Published 3 December 2024

Applies to England

What’s new

The following indicators have been updated with one or some of the following geographies of England, local authority, integrated care board (ICB), sub-integrated care board (sub-ICB), and regional areas:

• estimates for undiagnosed hypertension
• hospital admissions for coronary heart disease (CHD), heart failure and stroke
• mortality for coronary heart disease, heart failure and stroke
• care processes for stroke prevention and ongoing management
• kidney care for kidney replacement therapy and dialysis

The following indicators have been added to the profile from the CVDPREVENT audit:

• monitoring and treatment for chronic kidney disease (CKD)
• monitoring and treatment of hypertension and those with a high risk of developing cardiovascular disease (CVD)

Introduction

The CVD profile brings together data on the pathway of care and the outcomes for CVD, including:

• primary care and management of the disease and its risk conditions
• emergency care
• hospitalisation
• acute care procedures (including kidney care)
• mortality

By presenting disease outcomes and risk factors, these tools provide a single summary of the burden of CVD to:

• bring together data on the pathway of healthcare in one tool to enable users to access and utilise the intelligence more easily

• provide data for health professionals and local public health colleagues when assessing the impact of the disease on their local population and making decisions about services

• support users to identify and address inequalities in care between their areas and identify priority areas for further review

Main findings

This update shows:

• hospital admission rates for CHD have decreased by 46% from the financial year ending March 2004 to the financial year ending March 2024

• from 2022 to 2023 CHD premature mortality rates in persons have remained stable

• in England in 2022 the kidney replacement therapy (KRT) acceptance rate (6 year combined) remained stable, with little change from the previous year

Detailed findings

Heart disease and heart failure

In the financial year ending March 2023 there were just over 1,879,000 people (3%) with a general practice (GP) diagnosis of CHD in England. The rate of people in England with a recorded GP diagnosis of CHD has decreased since the financial year ending March 2010.

Hospital admission rates for CHD have decreased by 46% over the past 20 years to the financial year ending March 2024. There was also a 3-fold difference in admission rates for CHD between the counties and unitary authorities (UA) in England in the financial year ending March 2023 with the highest rate of 756.7 per 100,000 population in Tameside and the lowest of 231.5 per 100,000 population in Bournemouth, Christchurch and Poole.

The range in admission rates for heart failure between local authorities is larger than CHD with a 4-fold difference between counties and UAs in England with the highest rate of 396.5 per 100,000 population in Hounslow and the lowest of 104.0 per 100,000 in Bournemouth, Christchurch and Poole.

The rate of premature mortality from CHD in England has decreased every year from 2001 to 2019. However, since the increase between 2019 and 2022 CHD premature mortality rates have remained stable from 2022 to 2023. There is a clear deprivation gradient, with mortality rates for CHD in 2023 more than twice as high in the most deprived compared with the least in England; see figure 1 for details.

Figure 1: age standardised mortality rate for CHD by district and UA deprivation decile for persons aged under 75 years, England, 2023

Estimated prevalence of undiagnosed hypertension

Figure 2 shows the estimated proportion of people with undiagnosed hypertension in ICBs in England in 2021. The proportion of people with undiagnosed hypertension ranged between 7.8% and 9.4%, a 1.7 percentage point difference between the highest and lowest ICB areas (a 1.2-fold difference). All London ICBs were in the 6 areas with the lowest undiagnosed hypertension.

The simulated uncertainty limits are reasonably narrow, around 0.55 percentage points lower or higher than the estimated proportion and these are uniform in size across areas, as they are based on the Health Survey for England (HSE) study sample confidence intervals (by age bands and sex).

Figure 2: estimated undiagnosed hypertension prevalence in ICBs (and 95% CIs), 2021

Kidney disease

In the financial year ending March 2024 there were just under 2,238,000 people (4.4%) aged 18 years and over with a GP diagnosis of CKD in England. This is an increase from 2,093,000 from the previous year.

Kidney transplants continued as the most common KRT treatment modality (55%), 37% of people received in hospital dialysis and 8% home based dialysis. There was little change in the modality breakdown between 2021 and 2022.

Stroke

In the financial year ending March 2024 there were just over 1,175,000 people (1.9%) with a GP diagnosis of stroke or transient ischaemic attack (TIA) in England. The number of people with a recorded GP diagnosis of stroke or TIA in England has continued to rise since the financial year ending March 2010.

There was a 3-fold difference between the highest and lowest admission rates for stroke between the counties and UAs in England with 323.4 per 100,000 population in Gateshead and 109.8 per 100,000 population in Blackburn with Darwen in the financial year ending March 2024.

Revisions

The December 2024 update includes a revision to the 2021 KRT data for the NHS South West region and England. There was an incomplete data submission from one of the kidney centres which provides KRT services for people living in Devon and Somerset in 2021. This resulted in artificially low KRT acceptance rates and numbers of people receiving KRT for NHS Devon and NHS Somerset ICBs, and for the NHS South West region.

Therefore, all values for NHS Devon and NHS Somerset ICBs and sub-ICBs have been suppressed for 2021, and rates and proportions have been recalculated for NHS South West region and for England. For absolute numbers on KRT, the artificially low numbers for NHS Devon and NHS Somerset sub-ICBs have been included for aggregations to England.

Further information

Further details about the profile methodology are available within the definitions section of the online version of the CVD disease profile.

Product leads: Andrew Hughes, James Hollinshead

For queries relating to this document, please contact: [email protected].