Emerald Group Publishing Limited
Copyright © 2000, MCB UP Limited
Health survey of cardiovascular disease published
A report on the prevalence of cardiovascular disease and its risk factors was published at the end of 1999. The report is based on the 1998 results of the annual health survey, and includes comparisons with data from the 1994 survey. One of the key findings was that, although the prevalence of CHD decreased between 1993 and 1994, it increased again in 1998. The overall prevalence of stroke increased between 1994 and 1998. In men it rose from 7.1 per cent to 8.5 per cent and in women from 5.2 per cent to 6.2 per cent. The proportion with a CVD condition (angina, heart attack, stroke, heart murmur, abnormal heart rhythm, other heart trouble, diabetes or high blood pressure) was 28 per cent for both men and women. Excluding those with high blood pressure, the proportion was 16 per cent for men and 14 per cent for women. Social class had an impact on the incidence of coronary vascular disease and ischaemic heart disease (IHD). The age-standardised prevalence of IHD was 5 per cent of men in social class I compared to 11 per cent in social class IV and in women the prevalence was 6 per cent in social class II, and 10 per cent in social class V.
The report also considered the risk factors. Alcohol consumption did not show any significant change among men from 1994 to 1998 but rose among women. In 1998, on average, men were still drinking well over twice as much as women. No consistent trend in smoking prevalence was discernible between 1994 and 1998 but there was evidence of increased smoking in the 16 to 24 age group. A total of 28 per cent of men and 27 per cent of women reported smoking cigarettes. Smoking prevalence is highest in the lower income groups (42 per cent of men and 37 per cent of women) and lowest in the high income groups (21 per cent of men and 18 per cent of women).
The proportion of people who were either obese or overweight increased between 1994 and 1998. In the case of men, the number who were overweight increased from 58 per cent to 63 per cent and for women from 49 per cent to 53 per cent. The number who were obese increased from 14 per cent to 17 per cent for men and from 17 per cent to 21 per cent for women. Again, socio-economic variations were seen for overweight and obesity, increasing from social class I (14 per cent) to 28 per cent in social class V.
There was no evidence of an increase in high blood pressure during the period under review but the proportion of people with untreated high blood pressure decreased in both sexes. Using the new WHO definition for high blood pressure, 41 per cent of men and 33 per cent of women had high blood pressure. There was no evidence that social class affects blood pressure of men but for women high blood pressure increased from 30 per cent in the highest income group to 37 per cent in the lowest income group.
Overall, 18 per cent of men and 22 per cent of women had raised total cholesterol levels, with little variation by social class. When interviewed, 9 per cent of women were on hormone replacement therapy and 6 per cent had been users in the past. The proportion of women ever having used HRT increased sharply with age to 39 per cent at age 45-54 years and 41 per cent at age 55-64 years, falling to 12 per cent at 65-74 years, and 3 per cent at age 75 and over.
There was a marked decline of men's physical activity with increasing age from 54 per cent of men in the 16-24 age group meeting the current guidelines of at least 30 minutes of moderate intensity exercise at least five days a week to 32 per cent among those aged 55-64 years and 17 per cent among those aged 65-74 years. Women's activity levels were much lower than men's in the younger age groups with 32 per cent meeting the guidelines in the 16-24-year age group and did not decline much until after about the age of 55. A total of 21 per cent among those aged 55-64 years and 12 per cent among those aged 65-74 years met the guidelines.
The 1999 survey will focus on the health of ethnic minority groups and the 2000 health survey will look at the health of older people including those in residential and nursing homes. Copies of the full report Health Survey for England: Cardiovascular Disease 1998 are available from HMSO (ISBN 0113223072, price £75). The report and summary booklet are available on the DH Internet at: http://www.doh.gov.uk/public/summary.htm