GPs are playing a major part in reducing deaths from coronary heart disease (CHD) by prescribing more statins, ACE inhibitors and antihypertensives.
Practice-based registers of patients with CHD are also helping GPs to ensure that patients receive appropriate advice and treatment to prevent a first or repeat attack.
Winning the War on Heart Disease- a progress report on the CHD National Service Framework (NSF) - states that deaths from cardiovascular disease fell by more than 23 per cent between 1995-1997 and 2000-2002.
Since the NSF was launched four years ago, the NHS has increased its spending on statins by 30 per cent a year, with 1.8 million people (more than three per cent of the population) currently receiving statins. This is potentially saving 6,000 to 7,000 lives a year, as well as reducing the number of heart attacks.
Plans to make statins available over the counter without prescription are being considered.
The CHD NSF and now the new GMS contract state that GPs and primary care teams should develop a register of CHD patients. Through this they can review medication, offer advice on diet and lifestyle, and maintain the necessary contact with patients most at risk of suffering renewed heart problems.
The evidence shows that most practices already have CHD registers in place. The priority now is to ensure that, by March 2006, registers and systematic treatment regimes, including advice on diet and lifestyle, also cover patients at high risk of CHD.
Other initiatives to change patient behaviour (diet, smoking and exercise) are also expanding with support from the National Primary Care Collaborative.
New approaches in primary care are also having great success. The Wallasey Heart Centre, a primary-care based partnership, has helped to cut waiting times for routine hospital cardiology appointments from six months to six weeks. In the past three years only nine per cent of the centre's patients have been referred onto secondary care.
A specialist GP in cardiology performs twice-weekly assessments with same day advice and management to referring GPs and practice nurses. A cardiac rehabilitation service is also held twice a week and exercise and lifestyle services help those at risk.
