A groundbreaking new study has revealed how the landscape of heart disease in the UK has evolved over the past two decades.
Analysing data from 22 million people, the study found that most improvements in heart health have been seen in people over the age of 60, but that younger age groups haven’t experienced the same positive trends in the last 20 years. The new research is published in the BMJ and was conducted by a consortium of European researchers: the University of Glasgow, the University of Oxford, KU Leuven, and the University of Leicester.
Overall, the study found a 19% drop in the overall incidence (the number of new diagnoses) of heart-related diseases from 2000 to 2019, including major reductions in heart attacks and strokes, with incidences down by about 30%.
However, while heart attacks and strokes have decreased, the study reports an increase in diagnoses of other heart conditions such as irregular heartbeats, valve problems and blood clots. As a result of these varying trends, the overall incidence of cardiovascular disease across the ten conditions investigated has remained relatively stable since the years 2007-2008.
The study also highlights a troubling gap in heart disease rates between the rich and poor. People in the most deprived areas are nearly twice as likely to suffer from certain heart conditions compared to those in wealthier areas.
Researchers analysed electronic health records from the Clinical Practice Research Datalink (CPRD GOLD and Aurum), encompassing a representative cohort of 22 million individuals. This included 1,650,052 people newly diagnosed with at least one cardiovascular disease (CVD) between 2000 and 2019, with an average age of 70.5 years, of whom 48% were women.
The researchers say that despite significant strides in preventing heart attacks and strokes, the overall burden of heart disease remains high due to the rising incidence of other heart conditions. This means that while many people are benefiting from better heart health, there are still large segments of the population at risk, particularly younger people and those in economically disadvantaged areas.
Although the overall risk of developing cardiovascular disease before the age of 60 years is comparatively low, the fact that there were no improvements in the rate of coronary heart disease in younger age groups is of concern. This finding suggests that more efforts are needed to better identify those at high risk of developing cardiovascular disease at a young age and develop new strategies on how we could best prevent these.
Dr Nathalie Conrad, Honorary Research Fellow at the University of Glasgow, and lead author of the study, said:
“To date, cardiovascular disease prevention is largely focused on ischaemic heart disease and stroke. Our findings suggest that existing efforts have been successful in preventing, yet that other cardiovascular diseases increased in parallel. For example, our study shows that venous thromboembolism and heart block are now similarly common to heart attacks or strokes, yet these conditions receive much less attention in terms of prevention efforts.
“We hope that these findings will help raise awareness to expand research and prevention efforts to include the broader spectrum of cardiovascular presentations and their consequences.”
Professor John McMurray, Professor of Cardiology at the University of Glasgow, and senior author of the study, said:
“While it is good news that the incidence of coronary heart disease and stroke has decreased overall, the lack of decline in younger people, the rise in other serious conditions such as heart failure, and the persistent socioeconomic gradient in cardiovascular problems means much still has to be done to improve the most important cause of ill health in the UK.”
The study, ‘Temporal trends and patterns in cardiovascular disease incidence. A population-based study in 22 million individuals’ is published in the BMJ.