Treatment for heart disease must improve in deprived areas
http://www.100md.com
《英国医生杂志》
The government has made major steps forward in the treatment of heart disease in England and Wales, according to a report by the NHS inspection body, the Healthcare Commission. But it still needs to do more to target people most at risk of heart disease, particularly those in areas of social or economic deprivation, where rates of heart disease are still higher than normal.
The report looks at progress on the national service framework for heart disease, which was launched in 2000. People who have a heart attack are getting treatment more quickly now. Eighty five per cent of patients were given thrombolytic drugs in 2004 within the target time of 30 minutes of arriving at the hospital; in 2002 the figure was 59%. Of patients who were discharged from hospital in 2004 after a heart attack, nearly 94% receive statins, compared to 84% in 2002. The number of cardiologists has also increased since the framework was introduced, it says.
One in five men and one in six women in England and Wales die from coronary heart disease, according to the report, and 268 000 people each year have a heart attack.
The highest rates of coronary heart disease were found in large urban areas in the northeast, the northwest, Yorkshire, and Humberside, as well as in parts of the southwest, in London, and in smaller urban areas across central and southern England.
Mortality was highest in socially and economically deprived areas. This may be because people in these areas are more likely to smoke and eat a diet high in saturated fats, the report says. Although considerable progress in helping people to stop smoking has been made, there is less evidence that these services have been effective in deprived areas, it says.
But the measures taken by GPs to register people who have coronary disease have been very effective, more advice is being given about cholesterol lowering drugs, and two thirds of patients registered as having heart disease have been seen by their GP or community nurse in the last 12 months.
However, more could be done to identify patients at high risk of heart disease, to improve data about people known to have cardiovascular disease, and to ensure that cholesterol reducing drugs are prescribed more widely, particularly in areas with a high concentration of coronary heart disease.
Although death rates in the United Kingdom from heart disease have been declining and are now closer to rates in other European countries, including Spain, Italy, and France, more still needs to be done, said Anna Walker, the commission抯 chief executive.
"Overall this has been a good news story for the health service. There has been real and significant progress on what is unquestionably a top national priority. But none of us can afford to be satisfied until we have done everything possible to reduce the incidence of heart disease," she said.
Getting to the Heart of it, Coronary Heart Disease in England: A Review of Progress Towards National Standards is available at www.healthcarecommission.org.uk(London Lynn Eaton)
The report looks at progress on the national service framework for heart disease, which was launched in 2000. People who have a heart attack are getting treatment more quickly now. Eighty five per cent of patients were given thrombolytic drugs in 2004 within the target time of 30 minutes of arriving at the hospital; in 2002 the figure was 59%. Of patients who were discharged from hospital in 2004 after a heart attack, nearly 94% receive statins, compared to 84% in 2002. The number of cardiologists has also increased since the framework was introduced, it says.
One in five men and one in six women in England and Wales die from coronary heart disease, according to the report, and 268 000 people each year have a heart attack.
The highest rates of coronary heart disease were found in large urban areas in the northeast, the northwest, Yorkshire, and Humberside, as well as in parts of the southwest, in London, and in smaller urban areas across central and southern England.
Mortality was highest in socially and economically deprived areas. This may be because people in these areas are more likely to smoke and eat a diet high in saturated fats, the report says. Although considerable progress in helping people to stop smoking has been made, there is less evidence that these services have been effective in deprived areas, it says.
But the measures taken by GPs to register people who have coronary disease have been very effective, more advice is being given about cholesterol lowering drugs, and two thirds of patients registered as having heart disease have been seen by their GP or community nurse in the last 12 months.
However, more could be done to identify patients at high risk of heart disease, to improve data about people known to have cardiovascular disease, and to ensure that cholesterol reducing drugs are prescribed more widely, particularly in areas with a high concentration of coronary heart disease.
Although death rates in the United Kingdom from heart disease have been declining and are now closer to rates in other European countries, including Spain, Italy, and France, more still needs to be done, said Anna Walker, the commission抯 chief executive.
"Overall this has been a good news story for the health service. There has been real and significant progress on what is unquestionably a top national priority. But none of us can afford to be satisfied until we have done everything possible to reduce the incidence of heart disease," she said.
Getting to the Heart of it, Coronary Heart Disease in England: A Review of Progress Towards National Standards is available at www.healthcarecommission.org.uk(London Lynn Eaton)