Increase in cardiovascular diease

The amount of cardiovascular disease (CVD) in the population increased in 1998 according to a new survey by the Department of Health*. This finding is against the trend of recent years of continuous decline in the prevalence of coronary heart disease and strokes. It is not at the moment known whether the 1998 result is an abnormality or whether it indicates an halt to the underlying trend of improvement.

The debate of the role of alcohol and cardiovascular disease continues with the case for the protective effect of moderate drinking being frequently made. If the effect can best be described by the famous J shaped curve, with moderate drinkers enjoying greater cardiovascular protection than non-drinkers, then those who drink at higher levels are most at risk. Other factors, such as obesity, smoking, and level of exercise, as well as alcohol will have played a role in the increase of cardiovascular disease.

Alcohol consumption did not show any significant change among men from 1994 to 1998, but rose among women. Nevertheless, in 1998 on average men were still drinking well over twice as much as women. There was no consistent trend in smoking prevalence detected between 1994 and 1998, although there was evidence of an increase in smoking prevalence in those aged 16-24.

The proportion with a CVD condition such as 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.

7 per cent of men and 5 per cent of women reported a history of Ischaemic heart disease (IHD) which includes angina and heart attack. With the addition of stroke the proportions rose to 9 per cent for men and 6 per cent for women.

Men in the lower social classes were more than twice as likely to suffer strokes and the proportion was only marginally better in women. The proportion of women drinking more than 14 units of alcohol a week was at lower levels in manual social classes whilst, in men, variation by social class did not follow a clear pattern.

Of men who had an alcoholic drink in the past week, the proportion of those who had drunk at least 8 units on at least one day during that week increased progressively from Social Class I (24 per cent) to Social Class V (44 per cent). The proportion of women drinkers who had drunk at least 6 units on at least one day followed a similar pattern, 11 per cent in Social Class I and 23 per cent in Social Class V.

The survey says that 28 per cent of men and 27 per cent of women reported smoking cigarettes. Smoking prevalence varies greatly with household income, being lowest amongst those with the highest income.

* Health survey for England: cardiovascular Disease '98. Summary of key findings, Department of Health.