joint strategic needs assessment foundation profile - JSNA

Interative Hull Atlas: www.hullpublichealth.org/Pages/hull_atlas.htm More information: www.jsnaonline.org and www.hullpublichealth.org
10 SPECIFIC DISEASES/AREAS
10.1 Circulatory Disease
There are three main types of circulatory (cardiovascular) disease: coronary heart
disease (CHD), cerebrovascular disease and peripheral vascular disease.
Cardiovascular disease is usually caused by a build-up of fatty deposits on the walls of
the arteries. The fatty deposits, called atheroma, are made up of cholesterol and other
waste substances. The build up of atheroma on the walls of the arteries makes the
arteries narrower and restricts the flow of blood. This process is called atherosclerosis.
CHD is caused by the narrowing of one or more of the coronary arteries, which can
result in angina, heart attack or heart failure. Cerebrovasular disease (stroke and
transient ischaemic attack (TIA)) results from disease of the arteries in the brain. The
most common cause of a stroke is due to an artery in the brain becoming blocked by a
blood clot which is usually formed over some atheroma. A TIA is a disorder caused by
temporary lack of blood supply to a part of the brain. Peripheral vascular disease is also
a disease resulting from narrowing of the arteries due to atheroma, but arteries other
than those in the heart or brain (generally in the leg). See section 13.4.5 on page 811
for more information about the definitions used to define these conditions.
10.1.1 All Circulatory Disease
10.1.1.1 Risk Factors
The risk of developing atherosclerosis is significantly increased with smoking, high blood
pressure, high blood cholesterol level, lack of exercise, thrombosis, and diabetes. Other
risk factors for developing atherosclerosis include being overweight or obese, and
having a family history of heart attack or angina. An unhealthy diet influences high
blood pressure and cholesterol levels.
10.1.1.2 Diagnosed Prevalence
As part of the Quality and Outcomes Framework (QOF), general practices compile
disease and medical condition registers. From these registers, the prevalence of these
various conditions can be estimated. However, there may be a high proportion of
patients who have the disease or medical condition, but it is undiagnosed and the
patient is not included on the register(s). Furthermore, the figures are unadjusted for
influencing factors, such as the age of the patients and deprivation, but practices have
been grouped based on age and deprivation (see section 3.3.3.3 on page 47 for more
information). Practices with a high proportion of elderly patients and practices in the
most deprived areas will tend to have a higher prevalence of disease (and generally a
higher prevalence of undiagnosed disease). See section 12.13 on page 782 for more
information on QOF and issues associated with presenting the prevalence at practice
level. Also see Table 28 and Table 49 for mean age of patients and mean deprivation
Joint Strategic Needs Assessment Foundation Profile – Hull Health Profile: Release 3. March 2011. 434