Under-diagnosis of cardiovascular disease in England

Despite financial incentives to encourage general practices to register new cases, there is still under-diagnosis of cardiovascular disease (CVD) in England. In a paper published recently in BMC Cardiovascular Disorders, Michael Soljak colleagues compared the modelled (expected) and diagnosed (observed) prevalence of three cardiovascular conditions- coronary heart disease (CHD), hypertension and stroke- at local level, their geographical variation, and population and healthcare predictors which might influence diagnosis. They found that 9,682,176 patients were on practice CHD, stroke and transient ischaemic attack, and hypertension registers. There was wide spatial variation in observed: expected prevalence ratios for all three diseases, with less than five per cent of expected cases diagnosed in some areas. They concluded that despite access to universal, free primary healthcare, there may be substantial under-diagnosis of CVD across England.

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