NHS RightCare is a national NHS England-supported programme helping to ensure that the best possible care is delivered as efficiently as possible, and that this care is right for patients and will help ensure a sustainable NHS, now and for the future.
This article seeks to demonstrate the close relationship between cardiovascular disease and chronic kidney disease (CKD). It also highlights the importance of identifying people with CKD as a means of recognising people at high risk of both cardiovascular events and unplanned admissions.
Hypertension is the most important single risk factor for cardiovascular disease (CVD). It affects over 25% of adults in England, but more than 5.5 million people remain undiagnosed. Although the number of adults with untreated hypertension has fallen, England’s performance still lags behind achievements in countries such as Canada and the USA, and there is scope for improvement.
The first Health Survey England (HSE) in 1994 revealed a ‘rule of halves’ since only half of people with hypertension were diagnosed, of which half were treated and of those, only half were controlled. Have matters improved over the more than 20 years since the first HSE survey?
Approaches to the prevention of cardiovascular disease should be tailored to each individual. But almost everyone will benefit from lifestyle interventions that have been shown to reduce cardiovascular risk.
Volume 8, Supplement 2, Jul-Aug-Sep 2011
A few weeks ago I was out shopping, and bumped into Alan. On a very hot day, he was dressed up as ‘Artie Beat’ for a photo shoot outside a supermarket to promote fundraising for the British Heart Foundation. I was being nosey, as you might expect, and went over to see what was happening. When I congratulated Alan, he said: ‘I am only a cashier’. But no one is an ‘only’ when it comes to caring and making a difference. So thank you, Alan, and thank you, ASDA. I then started thinking about compassion on that large social scale and then about compassion from individuals.
A retrospective audit of premature deaths (aged under 75) from cardiovascular disease (CVD) in Leeds showed that patients diagnosed with CVD and placed on disease registers lived on average eight years longer than patients who had not been diagnosed prior to their deaths. If innovations like the NHS Health Check can be used to identify CVD patients in a more equitable manner, there is likely to be a major impact in reducing premature mortality with the potential to reduce health inequalities for disadvantaged groups in the population.
I was listening to the radio the other morning as the news was breaking that polyunsaturated fats seem to be no better for your heart than good old butter. My friend Mike Knapton from the British Heart Foundation was interviewed and in his radio clip he said: “Choose something for taste and texture!” Now I would bet my life savings, if I had any, that he was edited, and that he would have gone on to advise moderation in all things and that it is important to reduce the amount of fat in the diet.
The NHS Health Check offers 15 million people aged 40-74 years in England an assessment of cardiovascular risk, together with preventive interventions, once every five years. The programme has aroused some controversy, but there is an urgent need to take action now to reduce preventable, premature death and disability caused by vascular disease.
Well, how fast things change! The latest figures show that a massive proportion of practice nurses and nurse practitioners are going to retire in the next few years—me included, I guess. I am very aware that this exodus is already starting to have an impact on primary care, as I am receiving requests for advice from brand-new practice nurses, who may be established nurses but are not general-practice prepared. This is scaring me and should frighten everyone else.