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Reductions in risk factors for secondary prevention of coronary heart disease

The UK health care system provides universal coverage; hence, equitable health improvement across ethnic groups should be more easily attainable than in fragmented health systems. However, previous studies have shown ethnic health inequalities in cardiovascular disease prevalence, health outcomes and access to interventions and treatment in the UK. In a recent paper published in Family Practice, Joanna Murray and colleagues examined whether policy changes over the past decade in the primary care management of coronary heart disease (CHD), have resulted in improved and more equitable risk factor control among patients. The study was carried out in Wandsworth in South-West London.

They found that over a 10-year period from 1998 to 2007, mean blood pressure among patients with CHD decreased from 140/80 to 133/74 mm Hg, while their mean cholesterol was reduced from 5.2 to 4.3 mmol/l. Reductions in these risk factors occurred among both males and females and across all ethnic groups. The findings from this study illustrate how a national health care system with universal coverage can significantly improve care for all ethnic groups in a major long-term illness, such as CHD. This is in contrast to more fragmented health care systems such as in the USA, where ethnic disparities remain more marked than in the UK. Further reducing inequalities in chronic disease management should remain a priority for primary care in the UK.


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