What are heart and circulatory diseases?

The circulatory system controls the flow of blood around the body to organs and tissues. Diseases of the heart and circulatory system (sometimes referred to as the ‘cardiovascular system’) are those which affect the functioning of the heart and blood vessels and which make it harder for blood to flow freely through the body.

Examples include coronary heart disease, as well as stroke, vascular dementia and heart failure. The British Heart Foundation (PDF) notes that heart and circulatory diseases may be inherited or they may develop later in life. It estimates that there are approximately 7.6 million people living with heart and circulatory diseases in the UK.

Diseases of the cardiovascular system (CVD) are typically associated with the build-up of fatty substances in the arteries over time, causing them to narrow and disrupt the flow of blood, a process known as atherosclerosis. The NHS identifies the following risk factors for CVD:

  • High blood pressure
  • Smoking
  • High cholesterol
  • Diabetes
  • Inactivity
  • Being overweight or obese.

Those with a family history of CVD, and “people of south Asian and Black African or African Caribbean background”, are also identified by the NHS as at increased risk of developing CVD.

Premature deaths

NHS England reports that CVD is responsible for “one in four premature deaths” in the UK (a death that occurs in people aged under 75 years).

The premature mortality rate from circulatory diseases in England fell from 145 per 100,000 population in 2001 to 69 per 100,000 population in 2019. Since then it has risen slightly, to 77.8 per 100,000 population in 2022. This is approximately equivalent to the rate in 2012.

There is a socio-economic gradient to those premature deaths. Those in the most deprived 10% of the population in England were, in 2022, more than twice as likely to die prematurely from circulatory diseases than those in the least deprived 10% of the population.

Men are twice as likely to die prematurely from circulatory diseases as women in England. This gap has remained largely consistent for the last decade.

The premature mortality rate from circulatory diseases in 2022 was highest in the North West region (97.2 per 100,000), the North East region (90.8) and the Yorkshire and the Humber region (89.6). The rate was lowest in the South East region (63.1) and the South West (66.4).

You can view trends for England and for local authorities on the Office for Health Improvement and Disparities Fingertips data website.

NHS policies

This section sets out policy on cardiovascular disease (CVD) for the NHS in England. The Government also intends to publish a major conditions strategy, which would cover six conditions including cardiovascular disease.

NHS England cardiovascular disease policy

There is information on the NHS England website about cardiovascular disease (CVD), including ongoing work to tackle stroke, heart attack and cardiac arrest. Much of this relates to the 2019 NHS Long Term Plan ambitions to help prevent CVD (see Long Term Plan, CVD as a clinical priority).

The NHS England Getting It Right First Time (GIRFT) national report for cardiology (PDF), published in 2021, made the case for delivering services through cardiac and stroke delivery networks. These networks have been developed to take a clinically led, whole pathway approach from prevention, diagnosis, treatment to end of life care. Recommendations made in the report are being implemented through GIRFT and NHS England’s Cardiac Transformation Programme.

GIRFT and the Cardiac Transformation Programme have recommended an expansion of diagnostic capacity in echocardiography through the roll out of Community Diagnostic Centres (CDCs). Steps taken include rolling out up to 160 CDCs which will provide echocardiography services by March 2025 (see PQ200324, 16 October 2023).

A National Stroke Programme has been developed jointly by NHS England and the Stroke Association in consultation with a wide range of clinical experts and people affected by stroke. The programme supports local organisations to meet the ambitions for stroke set out in the Long Term Plan to deliver better prevention, treatment and care for the 85,000 people who have a stroke in England each year.

The NHS Health Check programme aims to prevent heart disease, stroke, type 2 diabetes and kidney disease, and some cases of dementia among adults aged between 40 and 74 years old.

Major conditions strategy

On 24 January 2023, the Government announced that it will publish a major conditions strategy. The strategy will cover six major condition groups that account for around 60% of ill-health and early death in England, including cardiovascular disease. In a written statement to Parliament on 24 January 2023 (HCWS514), the then Health Secretary Stephen Barclay said the strategy would set out a shift to integrated, whole-person care. In August 2023, the Government published the Major Conditions Strategy: case for change and our strategic framework.

Further reading

 House of Commons Library debate briefings:

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