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Background and Policy

Heart Disease

NHS National Services Scotland ISD Scotland & NHS National Services Scotland

Background & Policy

Heart Disease & Stroke

Coronary heart disease (CHD) is a disease of the heart and coronary arteries caused by the build up of fatty materials in the blood vessels that supply the heart with oxygen. This can cause a heart attack, chest pain or angina. Cerebrovascular Disease, which includes cerebrovascular accident/stroke and transient ischaemic attack (TIA), is responsible for the deaths of more than 4,000 people in Scotland every year. A stroke or TIA happens when the blood supply to part of the brain is interrupted and the brain cells are starved of oxygen. This usually occurs because a blood vessel becomes blocked. Stroke is more common in older people.

Risk factors associated with CHD & stroke

The main preventable risk factors for coronary heart disease and stroke are smoking, lack of exercise and a poor diet. Research also indicates a strong relationship between social deprivation and these risk factors.

Detailed information on the prevalence of these risk factors is available from the Scottish Health Survey.

Policy Context

NHSScotland service provision for patients with coronary heart disease and stroke operates within the framework of policy devised by the Scottish Government. A chronology of policy documents that steer service provision for CHD & stroke patients is outlined below.

The ISD's Data Quality Assurance (DQA) team is responsible for evaulating and ensuring SMR datasets are accurate, consistent and comparable across time and between sources.

The DQA team's previous projects web page contains details of past Data Quality Assurance Assessments, including final reports and findings.

The most recent report "Assessment of SMR01 Data 2010-2011" Download pdf file [350kb] was published in May 2012. This report includes feedback on clinical coding accuracy, sensitivity and completeness within defined groups and includes commonly encountered conditions including Ischaemic Heart Disease, Cerebrovascular Disease and Myocardial Infarction.

An earlier report, "Towards Better Data from Scottish Hospitals: An Assessment of SMR01 and Associated Data 2004-2006" Download pdf file [1.77Mb], contains sub-sections on specific conditions and interventions, including some related to CHD.

In hospital discharge data, clinical information for diagnoses and operations/interventions is currently recorded using, respectively, ICD10 (the International Classification of Diseases 10th Revision maintained by the World Health Organization (WHO)) and OPCS4 (the Office of Population Censuses & Surveys 4th Revision Classification of Surgical Operations and Procedures maintained by the Department of Health's directorate NHS Connecting for Health (CfH)).

Lists of ICD10 codes are available at OPCS4 codes are available from

For an extract of OPCS4 codes related to the heart see the file OPCS4 Classification of Surgical Operations and Procedures (Heart) Download pdf file [91kb] for details of the heart operations and procedures in its Chapter K. This document should be read in conjunction with the Information Standards Board document Summary of Changes from OPCS-4.6 to OPCS-4.7 Download pdf file [109KB] for details of the latest updates to the coding classification.

Independent & voluntary sector

Although there are a number of independent & voluntary sector organisations involved in the provision of information and services to CHD & stroke patients, two of the main ones, with links to NHSScotland, are the British Heart Foundation (BHF) and Chest, Heart & Stroke Scotland (CHSS). Both organisations are involved in the funding of research and provide extensive information for patients and carers on their respective web sites at and

Further Information

Our Links to other sources section offers a few examples of other information sources.

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