CORONARY HEART DISEASE (CHD)
A vascular disease in which the arteries supplying blood to the heart (coronary arteries) are narrowed by atherosclerosis. CHD leads to myocardial infarction, and is the most common cause of death in the UK (one in five deaths in men and one in six deaths in women). Death rates are higher in Scotland than the South of England, in manual workers than in non-manual workers and in certain ethnic groups. Mortality is falling, but morbidity is rising, e.g. among heart attack survivors who develop heart failure. See also cardiovascular disease, atherosclerosis
Prevention of coronary heart disease NICE Public health guidance (PH25) https://guidance.nice.org.uk/PH25
Coronary heart disease: mortality and morbidity statistics. Heartstats (BHF Statistics website) https://www.heartstats.org
CHD is largely preventable by action to reduce known modifiable risk factors for atherosclerosis.
Primary prevention aims to stop heart disease developing in a population. The NHS Health Check programme seeks to identify and manage individuals aged 40–74 years at high risk of cardiovascular disease (CHD, stroke, diabetes and kidney disease).
NHS Health Check https://www.healthcheck.nhs.uk
NICE. Prevention of coronary heart disease Public health guidance (PH25) https://guidance.nice.org.uk/PH25
Risk can be assessed using charts or on-line tools.
Practice Nurse featured article
Statins, CVD prevention and the practice nurse Dr Ed Warren
Back to basics: assessing cardiovascular risk Linda Edmunds
Practice Nurse Curriculum Modules
Secondary prevention aims to halt progression of symptomatic CHD, e.g. angina, myocardial infarction. Evidence is strong that targeting people with CHD for risk-factor modification reduces the risk of recurrent CHD. Prevention measures
Practice Nurse featured articles
Secondary prevention of cardiovascular disease. Dr Ed Warren
Cardiovascular disease: what the guidelines say. Dr Ed Warren
Practice Nurse Curriculum Module
Training in cardiovascular disease risk assessment
eLearning distance learning from Education for Health. https://www.educationforhealth.org/shop.php/courses/135/cardiovascular-disease-risk-assessment
The Heart Manual is an evidence-based supported self-management cardiac rehabilitation programme for people with coronary artery disease, widely used in the UK and overseas. It is suitable for most patients who have/have had:
coronary interventions (PCIs)
The Heart Manual NHS Lothian
Every patient with CHD should be seen at least annually, with fasting blood results, urine test results and blood pressure reading. Ensure use of correct Read codes.
British Cardiac Society www.bcs.com
British Heart Foundation www.bhf.org.uk
HEART UK - The Cholesterol Charity www.heartuk.org.uk
Chest, Heart and Stroke Scotland www.chss.org.uk