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Reducing the risk of cardiovascular disease, diabetes and kidney disease


In a  recent article in the New Perspectives Part II Section of  the SGIM Forum, the newsletter of the US Society of General Internal Medicine, I discuss the NHS Health Checks Programme. The burden of cardiovascular disease, type 2 diabetes and kidney disease will increase, both in developed countries with ageing populations, and in developing and middle income countries that are undergoing economic and demographic transitions. These diseases all share risk factors that include smoking, hypertension, obesity, physical inactivity, and impaired glycemic status. Integrated approaches to their prevention, early identification and effective management could therefore have major public health and economic benefits, and help limit the impact of the predicted future rise in non-communicable diseases. For example, even very modest reductions in population risk factor prevalence could prove to be highly effective in reducing the impact of these diseases.

Despite downward secular trends, as in other developed countries, cardiovascular disease remains the largest single cause of mortality in England, accounting for around 34% of deaths annually. Cardiovascular disease also contributes significantly to health disparities, with risk factors, prevalence of established disease, adverse health outcomes and premature highest in people from lower socio-economic and ethnic minority groups. In an attempt to address the high burden resulting these diseases, NHS Health Checks, a population wide primary prevention program, was established by the Department of Health for England in 2009. The program is a major investment in “upstream” health promotion and disease prevention activities; and evidence of a serious attempt by England's National Health Service to improve public health and to contain health service spending on treating potentially preventable diseases.

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