Coronary Heart Disease
Background & Policy
Coronary Heart Disease (CHD) & Stroke
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. Stroke is a "brain attack", caused by a disturbance to the blood supply to the brain. Both CHD and stroke are classed as types of cardiovascular disease (CVD). (source *)
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, the latest available survey being 2008. The 2003 survey included a specific report on Cardiovascular Diseases. You may also wish to refer to previous Scottish Health Survey reports from 1995 and 1998. Currently the Scottish Health Survey is running continuously from 2008-2011.
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.
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Delivering for Health (2005) (Scottish Government response to the "Kerr" report "Building a health service fit for the future")
The Scottish Government, in their 2009 action plan, reiterate their target of reducing premature mortality from coronary heart disease by 60% between 1995 and 2010.
Data Quality
ISD's Data Quality Assurance team was established in 1990. The team is experienced in clinical coding and in other aspects of medical records and information work. Its main remit is the routine assessment of the quality of data held on the national SMR database.
The most recent report "Towards Better Data from Scottish Hospitals: An Assessment of SMR01 and Associated Data 2004 - 2006" (1.77Mb) was published in September 2007 and may be viewed or downloaded.
The report contains sub-sections on specific conditions and interventions, including some related to coronary heart disease.
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)).
For ICD10 codes, see http://www.who.int/classifications/icd/en/ (WHO) and for OPCS4 codes see http://www.connectingforhealth.nhs.uk/systemsandservices/data/clinicalcoding/codingstandards/opcs4 (CfH). For an extract of OPCS4 codes related to the heart see the file below.
Extract from OPCS4 Classification of Surgical Operations and Procedures (Heart)
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 http://www.bhf.org.uk/ and http://www.chss.org.uk/
Further Information
Our "Links to other sources " section offers a few examples of other information sources.
Adam Redpath
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