Cardiovascular Disease in Camden

This assignment analyzes the issue of cardiovascular disease within Camden, highlighting its importance and impact on the local community. It delves into various resources, including the National Service Framework for Coronary Heart Disease, BACPR Standards, and local government reports. The analysis also encompasses relevant research studies conducted in Camden, such as those led by Camden CCG and UCL Partners, shedding light on prevention efforts and initiatives.

The impact of government
strategies on the prevalence of
cardiovascular in Camden
borough of London

TABLE OF CONTENTS
TABLE OF CONTENTS................................................................................................................2
Chapter 1: introduction....................................................................................................................1
Background..................................................................................................................................1
Rational of the project.................................................................................................................1
Importance of the topic to Health................................................................................................2
Aim of the project........................................................................................................................2
Objectives of the project..............................................................................................................2
Policies/ legislations/ strategies and agency................................................................................2
Literature search strategy.............................................................................................................4
Search engines.............................................................................................................................4
Database.......................................................................................................................................4
Exclusion and inclusion criteria...................................................................................................5
Chapter 2: Literature Review 1200..................................................................................................7
Strategies of government of London regarding cardiovascular Disease.....................................9
references.......................................................................................................................................13

LIST OF TABLES
Table 1: Search Terms.....................................................................................................................4
Table 2: Database............................................................................................................................4

CHAPTER 1: INTRODUCTION
Background
For the first time since the BHF (British Heart foundation) was formed, cardiovascular
disease is no longer a leading cause of death in the United Kingdom. In 2012, cardiovascular
diseases (CVD) caused 28% of all deaths while cancer caused 29% (Cardiovascular Disease
Statistics 2014, 2014). So, it has reflected decline in the rate of mortality by CVD. As per the
view point of Levy, 2013, there are different types of cardiovascular diseases such as Coronary
heart disease, Stroke, Diseases of arteries, arterioles and capillaries, other heart disease,
Hypertensive diseases as well as other diseases of the circulatory system in which Coronary heart
disease is the major issue of death from CVD (Levy, 2013). As per the statistical facts and
figures, around 41000 deaths were from stroke in which 6% of male and 9% of female. But, as
per the current scenario, government of the nation is trying to reduce this health issue and
develop different rules, regulations, policy as well as legislations for reducing the death rate from
CVD (Rydén and et.al, 2013).
Rational of the project
Prevalence of cardiovascular diseases (CVD) is very high in all over the London but
death rates of individuals are decreasing in Camden borough of London. So, author wants to
determine the major reason behind this difference. It is an issue because Camden borough of
London is facing some social issues also such as low income, inequality, housing issue,
homelessness, wordlessness, low pay, benefits and welfare reforms, low level of education and
health, etc. but, still death rate from CVD is low as compare to other areas (Daviglus and et.al,
2012). It is an issue now because government of the Landon has introduced different policies,
legislations, strategies and agencies for reducing the rates of prevalence of cardiovascular in
Camden borough of London (Camden, 2016). But, still no one has analysed the impacts of all
these strategies of government on prevalence of CVD in London. So, author has chosen the
current research subject for the whole investigation. For resolving this issue, researcher will shed
light on different strategies of government and effects of these strategies on CVD rates in
Camden borough of London. Overall, strategies will discover that how government strategy
1 | P a g e

helps in reducing the rates of occurrence of CVD in Camden borough of London (General
practice in London, 2016).
Importance of the topic to Health
Topic of the researcher is determining the impact of government strategies on the
prevalence of cardiovascular in Camden borough of London. This topic is important because it
will help in identifying the effects of government efforts in reducing the rate of CVD (Ormerod
and Ulrich, 2013). Along with this, research subject will also provide different suggestions for
improving government strategies.
Aim of the project
To critically analyse the impacts of government strategies on the prevalence of
cardiovascular in Camden borough of London.
Objectives of the project
 To determine different strategies of the government of London which focuses on
cardiovascular.
 To critically analyse whether government strategies of London reduce the prevalence of
cardiovascular in Camden borough of London or not.
 To provide appropriate suggestions for reducing the problem of cardiovascular in
Camden borough of London.
Policies/ legislations/ strategies and agency
There has been an establishment of Health and wellbeing board that are taking the
responsibility for assessing the heath needs of local population so as to reduce the events of
CVD. HEART UK welcomed this initiative which has resulted in giving a careful consideration
towards CVD risk, its prevention as well as management.
There has further been a presence of NHS Health Checks Programmed that has resulted
in significant improvemwww.camden.gov.uk/jsnaent in CVD outcomes. The Programme
focused on identifying the risk factors related to onset of cardiovascular disease, bringing
lifestyle changes and undertaking treatment efforts where a necessity felt. This check has further
aided in bringing a behavioral change in form of encouraging the patient to adopt healthy
lifestyle. The program even received good support from political arena and was also listed in
national performance measures for the NHS Operating Framework of England.
2 | P a g e

NICE has released a set of formal guidance so as to prevent the spread of cardiovascular
disease. The guidance has released a set of recommendations (Preventing cardiovascular disease.
2016). These are inclusive of banning the Trans fats in foods, making use of traffic light system
on the foods as well as drink products that are sold in England (Cardiovascular disease
prevention, 2016).
There has further been an establishment of National Service Framework for Coronary
Heart Disease that acts as a blueprint for tackling of heart disease. It has made an attempt to set
standards as well as services to be made available throughout England. The framework has made
an attempt to recognize the importance of wide ranging action that can be taken to reduce the
onset of cardiovascular disease. It has further set out an array of high quality treatment and care.
This is in terms of early digenesis, undertaking prompt action, providing high quality medical,
surgical and nursing care as well as specialist services in form of heart surgery and rehabilitation
(National Service Framework for Coronary Heart Disease, 2016).
Committee on Preventing the Global Epidemic of Cardiovascular Disease has proposed
for a conceptual model that emphasizes on determinants related to cardiovascular health as well
as its role in health education, communication and delivery of healthcare. The model has further
aided in identifying the specific policy approaches so that the individuals can make healthful
choices (Pearson, 2011).
There is further a presence of British Association for Cardiovascular Prevention and
Rehabilitation that has set 7 core standards that are to be followed by patients, commissioners as
well As health care professionals so as to bring in a behavioral change followed by educating the
masses about approaches towards prevention of cardiovascular disease (The BACPR Standards
and Core Components for Cardiovascular Disease Prevention and Rehabilitation, 2016).
The government of UK has further made an attempt to work towards the concept of
Quality assurance at both local as well as national level. This is with respect to Cardiac
Rehabilitation. It has been done by being in close alliance with National Audit for Cardiac
Rehabilitation (NACR). The alliance has further made an attempt to assure quality by providing
for a set of standards so as to monitor the processes.
Literature search strategy
Current investigation is based on literature review and for selecting appropriate literature,
researcher will use different search terms such as government strategies, cardiovascular and
3 | P a g e

Camden borough of London (Go and et.al, 2014). These search terms help in getting the most
appropriate literature which will play an important role in getting answer of all formulated
research questions.
Table 1: Search Terms
Search 1 Government strategies
Search 2 Cardiovascular
Search 3 Camden borough of London
Search 4 Search 1 AND Search 1 AND Search 3
Search engines
Researcher will use different search engines for conducting research and selecting
appropriate literature. But, author will chose only those search engines which support English
language and have sufficient storage of information (Daniel and Sam, 2011). These include
Google, Yahoo, Bing, Gigablast, etc.
Database
For searching relevant case studies and literature, author will use different databases
which will help in getting actual facts and figures relevant to the Cardiovascular in Camden in
London. Brief description about these databases is as follows:
Table 2: Database
DATABASES SELECTED DESCRIPTION
PubMed It includes more than 25 million research papers and articles
on the basis of different health issues and medical procedures.
Emerald insight It is an important group of database including number of
books, journals and other research articles on different
subjects such as health and social care, management,
education and engineering (Flick, 2011).
British Nursing Index This database includes information about nursing and
midwives of the UK and includes more than 400 UK journals
of health and social care.
CINHAL It is the world largest source of getting information about
nursing as well as health researches and includes more than
4 | P a g e

4000 research journals.
Google scholar It is a scholarly based research article which provides
appropriate data on different subjects (Fiegen, 2010).
Science Direct This database includes 12 million articles from 3,500
academic journals and 34,000 eBooks. It focuses on in-depth
research studies on different science subjects.
Exclusion and inclusion criteria
For getting appropriate literature, researcher will decide appropriate inclusion and
exclusion criteria. These criteria will help in finding suitable information for resolving research
issue and getting appropriate solution of each and every research question (Go and et.al, 2014).
Inclusion and exclusion criteria for the current investigation are described as under:
Inclusion Criteria:
For selecting appropriate literature, researcher will include only those research papers and
articles which have published after 2010. Along with this, author will comprise that literature
which has used English language. In addition, researcher will select research articles on the basis
of key words and include only those articles which are based on Government strategies,
Cardiovascular and Camden borough of London. Overall, inclusion criteria of the current
research are very specific so, it will help in collecting appropriate data for the whole
investigation (Daniel and Sam, 2011).
Exclusion Criteria:
There are some specific criteria by which author will exclude some articles and not use
any information in the current investigation. All those research papers or articles which have
published before 2010 will be excluded by researcher. Similarly, research papers and case
studies which have not used English language will also be excluded by researcher. In addition,
author will assure about that selected literature must be based on aim and objectives of the
current investigation else author will exclude that article (Flick, 2011).
5 | P a g e

CHAPTER 2: LITERATURE REVIEW 1200
Literature Review can be defined as a text of scholar paper that includes curer went knowledge n
the topic based on the findings, theoretical and methodological contributions. It acts as a basis
for carrying out future research (Jose, 2015). The current section will deal with identifying the
available literature that is present on the topic of CVD. This section will start with providing a
general context on given subject area followed by breaking down the objectives into thematic
headings and subheadings where the findings of secondary research will be presented.
Cardiovascular Disease overview
As per view of Anthony, George, Eaton, 2014 Cardiovascular disease (CVD) is meant for heart
or blood vessels where there is a reduction in flow of blood to heart, brain or body on account of
blood clot formation. It may further occur due to deposition of fat inside the artery which causes
the creation of hardening as well as narrowing of artery (Anthony, George, Eaton, 2014). It is
thus inclusive of a variety of conditions such as angina, heart attack, congenital heart disease,
stroke etc. These form the diseases of heart and circulation. The risk factor in this context is
inclusive of chain smokers, people with High blood pressure and cholesterol, those who remain
physically inactive and are obese. It has further been found on the basis of research study done
by Mozaffarian, Katan, Ascherio, 2006 that the individulas suffering from Diabetes further
have a presence of developing the disease (Mozaffarian, Katan, Ascherio, 2006). In the same
manner, males have a likely chance of developing CVD in comparison to females. This is
followed by advancing age that increases the chances for CVD development. Studies have
further found that South Asian population from India, Pakistan, and Bangladesh that are residing
in UK have got higher chances of getting the disease followed by premature death. This is on
account of disadvantaged socio-economic status as well as consumption of diet that is
'proatherogenic (Chow and et.al., 2007). The more risk factors a person has, the more are
chances for developing CVD. In case a person is not able to reduce risk factors then precautions
should be taken to protect heart.
Cardiovascular Disease in UK and Camden borough of London
CVD has been regarded as a leading cause of death especially premature mortality in London as
well as Camden which exists for all ages. It has further been regarded as a leading cause of
6 | P a g e

disability which may lead to stroke and heart failure. It may further lead to increasing the cost of
health care utilization (What is the issue, 2016). The cost of managing CVD by healthcare
system of UK has been estimated to be £8.7 billion (Epidemiology of Coronary Heart Disease,
2016),
Study by Bhatnagar and et.al. 2015 have concluded that premature mortality rates from CVD is
quite higher in men in comparison to women (Bhatnagar and et.al., 2015). Oyebode and et.al.
2014 has further researched that people who are suffering from mental illness as well as learning
disabilities have got a higher risk towards development of CVD related conditions in comparison
to general population (Oyebode and et.al., 2014). This is as person with a CVD is not known to
Gp and hence face difficulty in there systematic management. The risk factor for the disease is
further inclusive of high blood pressure, inactive lifestyle, overweight or obese as well as
Hypertension. As this conditions are quite prevalence in London hence the chances of CVD is
higher.
Statistics from Camben has revealed that there has been a decrease in Mortality rates from CVD.
The reduction has been noted out to be in a percent of 52 as compared to 56 for London as well
as England (cardiovascular disease, 2016). Camden has further seen a faster decline in
emergency admissions for CHD which is 41 percent. This is in comparison to England and
London which stands to be 23 (How important is this issue in Camden? 2016). However it is
further true that the rate of premature mortality in t deprived areas of Camden is more for male as
compared to female population.
Strategies of government of London regarding cardiovascular Disease
Timmis, 2015 has concluded that “UK government has introduced National Service
Framework (NSF) strategies for reducing the population burden of coronary heart disease (CHD)
(Timmis, 2015)”. As per the facts and figures CHD is one of the most common causes of death
in the UK so, government wants to reduce the risk factors and number of CHD patients by
improving treatment for people with established CHD. For early diagnosis and prevention of
different coronary heart diseases, UK government has also adopted different strategies such as
NHS health check programme which targets individual of age group 45-75 which were not
diagnosed with any cardiovascular disease earlier. The main focus of introducing this health
check programme is to prevent individuals suffering from different heart disease due to smoking
7 | P a g e

and other problems in UK. It also aims at reducing the morbidity rate and number of deaths in
the Camden borough of London.
According to different studies presented in recent years it has been found that 12% of
Camden borough of London is affected by different heart disease (Forster and et.al., 2014). 36%
of individuals from that group are known to suffer from heart failures and bronchial disorders
which are caused due to smoking. Based on this statistics UK, government structured cardiac
rehabilitation programmes which offered necessary guidelines and measures to all those patients
who experienced heart attacks and other coronary heart diseases. A team of dedicated physicians,
nurses, physiotherapists and other healthcare professionals were appointed by UK government so
that they assess and prescribe drugs to the patients accordingly.
8 | P a g e

CHAPTER 3 - APPLICATION
This chapter will deal with analyzing the relevant policies/ strategies/ legislation that have been
undertaken by UK government for tackling the issue of CVD. This would be done by analyzing
the already available literature.
What is being done to address the issue in Camden?
Government of UK also adopted many ways in Camden so as to address the issue. First is
the Primary prevention where people are prevented from undertaking unhealthy behaviors, such
as smoking, an unhealthy diet and lack of physical activity. The government has thus started
nutritional education, nutritional education, nutritional education and undertaking smoking
cessation services so as to bring a reduction in CVD cases.
There has further been a presence of NHS Health Check programmer where a risk
assessment is carried out so as to check the onset of CVD in population. The programmer has
made sure to undertake preventative strategies so as to reduce risk for CVD and raise awareness
of all. In Camden the program has been extended to people that are over the age of 35 and if they
belong to South Asian origin. This is as the risk for development of CVD is more for this
population group. Currently Camden has provided NHS Health Checks in its primary care as
well as outreach services. This is further followed by provision of Follow Up service by making
use of motivational techniques and signposts to suggest preventive actions across the borough.
The program has further ensured to invite all within the age range of 40 and 74 to have a risk
check followed by receiving the support by which risk can be managed. This has thus been
regarded as preventative programmer which is designed to assist people in staying healthier for
longer and avoid diseases such as CVD. It is thus carried out by early identification as well as
proper management of risk factors,
Adult weight management programmer has also been started in Camden where physical
activity and educational sessions are given to those people who are overweight.
9 | P a g e

Local Enhanced Service (LES) identified the need to work on the issue of CVD within Camden
region. The center has focused on increasing the number of diagnoses so as to close the gap that
exists between expected and actual recorded number of diseases.
Camden CCG has worked in collaboration with Royal Free London NHS Foundation Trust as
well as National Institute of Cardiovascular Outcomes so as to design a framework for
supporting patients as well as clinicians so as to prevent the onset of CVD. This has ensured to
redefine the approaches by which the disease can be prevented (Cardiovascular prevention
research study, led by Camden CCG, opens at The Royal Free, 2014). The framework further
involves for carrying out clinical audits of patients’ and receiving insights by interviews and
focus groups. These are inclusive of carers, families, patients as well as clinical specialists. The
study was conducted in hospitals through a team of cardiology and the stroke. It was opened for
a time span of 12 months. The analysis completion then took place in the span of six months.
The outputs allowed people to work with hospitals for better tailoring of services followed by
carrying out preventative programmes in context f the people who are at the risk of developing g
cardiovascular disease. This framework has thus made a huge impact on the overall wellbeing as
well as health status of people in local community of Camden (NICOR UCLP cardiovascular
prevention research study, 2014).
10 | P a g e

CHAPTER 4 CONCLUSION
From the study it has been found that CVD is a major issue in UK as well as Camben but there
has been a drastic reduction in cases on account of the strategies, policies and legislations that
were and are being undertaken by UK government. The strategies have led to effective diagnosis
of the disease. Suggestion of prevention measures by government from time to time has further
ensured towards reducing the impacts. Varied areas can further be suggested to the government
for bringing a reduction in onset of CVD.
 >There is a requirement o part of Public health England to develop programs and
procedures for improving the literacy about CVD management in conjunction with health
care professionals and patient representatives that are expert in this area.
 In the similar manner, local authorities and clinical commissioning groups are required to
work in increased cooperation with each other so as to ensure towards delivery of high-
quality health services. This will further ensure that the services are provided to hard-to-
reach and lower income socio-economic groups so that they can get access to best
opportunities
 There is further a need to bring in improvement with respect to Public health funding. If
it is proper then there can be a significant reduction with respect to health inequalities.
 NHS Commissioning Board is required to undertake leadership so as to manage the rare
forms of inherited (cardiovascular) conditions. This will aid in there better diagnosis and
management.
11 | P a g e

CHAPTER 5 REFLECTION
Present research was carried out with a motive to assess the impact of government strategies on
the prevalence of cardiovascular in Camden borough of London. . With this purpose, I gained a
deep insight about the concept of cardiovascular diseases. The given report has acted as a huge
source of eLearning for me in order to understand the prevalence of CVD in UK, Camden in
particular. I got to know about the presence of health inequalities. The research has further
supported me to gain information about the steps that have been undertaken by the local
authorities in this area. The report further taught me about the skill of intense research so as to
get the crux of entire research topic. I further learnt about the art of time management which
aided me in completing the dissertation in a timely manner. Conducting this research acted as a
remarkable experience. In this respect if research is done there next tie then I will do differently
by focusing on the skimming technique so as to save my time in carrying out unnecessary
research. I will also make sure to be in close coordination with the mentor so as to gaining better
ideas about the research practice and improve my ways of conducting it.
12 | P a g e

REFERENCES
Books and journals
Anthony, D., George, P., Eaton, C.B., 2014. Cardiac risk factors: environmental,
sociodemographic, and behavioral cardiovascular risk factors. FP Essent. 421. Pp.16-20.
Bhatnagar, P., and et.al., 2015. The epidemiology of cardiovascular disease in the UK 2014.
Heart.
Chow, C.K., and et.al., 2007. Families of patients with premature coronary heart disease: an
obvious but neglected target for primary prevention. BMJ. 335(7618).pp.481-5.
Daniel, S. P. and Sam, G. A., 2011. Research Methodology. Place of Publication, Country: Gyan
Publishing House.
Daviglus, M. L. and et.al, 2012. Prevalence of major cardiovascular risk factors and
cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the
United States. Jama. 308(17), pp.1775-1784.
Fiegen, M. A., 2010. Systematic review of research methods: The case of business instruction’,
Reference Services Review. 38(3). pp. 385–397.
Flick, U., 2011. Introducing Research Methodology: A Beginner's Guide to Doing a Research
Project. Place of Publication. Country: SAGE.
Forster, A.S., and et.al., 2015. Estimating the yield of NHS Health Checks in England: a
population-based cohort study. Journal of Public Health. 37(2). pp.234-240.
Galvan, José L., 2015. Writing Literature Reviews: A Guide for Students of the Social and
Behavioral Sciences (6th ed.). Pyrczak Publishing.
Go, A.S. and et.al, 2014. Heart disease and stroke statistics-2014 update. Circulation. 129(3).
Levy, L.B., 2013. Dietary strategies, policy and cardiovascular disease risk reduction in England.
Proc Nutr Soc. 72(4). Pp.386-9.
Mozaffarian, D., and et.al., 2006. Trans fatty acids and cardiovascular disease. N Engl J Med.
354(15). Pp.1601-13.
Ormerod, J. R. and Ulrich, W., 2013. Operational research and ethics: A literature review.
European Journal of Operational Research. 228(2). pp. 291-307.
13 | P a g e

Oyebode, O., Gordon-Dseagu, V., Walker, A. and Mindell, J.S., 2014. Fruit and vegetable
consumption and all-cause, cancer and CVD mortality: analysis of Health Survey for England
data. Journal of Epidemiology and Community Health.
Rydén, L. and et.al, 2013. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases
developed in collaboration with the EASD. European heart journal. 34(39), pp.3035-
3087.
Timmis, A., 2015. Cardiovascular mortality in the UK: good news if you live in the South.
Heart.
Online
Camden, 2016. [Online]. Available through: <
http://www.londonspovertyprofile.org.uk/indicators/boroughs/camden/>. [Accessed on
16th March 2016].
Cardiovascular disease prevention. 2016. [Online]. Available through:
<https://www.nice.org.uk/guidance/ph25/chapter/1-recommendations>. [Accessed on 16th
March 2016].
Cardiovascular Disease Statistics 2014, 2014. [Online]. Available through: <
file:///C:/Users/Preeti/Downloads/bhf_cvd-statistics-2014_web.pdf>. [Accessed on 16th
March 2016].
General practice in London, 2016. [Online]. Available through: <
http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/general-practice-
in-london-dec12.pdf>. [Accessed on 16th March 2016].
National Service Framework for Coronary Heart Disease. 2016. [Online]. Available through:
<https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/
198931/National_Service_Framework_for_Coronary_Heart_Disease.pdf>. [Accessed on
16th March 2016].
Pearson, T., 2011. Recent Advances in Preventive Cardiology and Lifestyle Medicine.
Circulation. 2011. 124. Pp. 2560-2571.
The BACPR Standards and Core Components for Cardiovascular Disease Prevention and
Rehabilitation, 2016. [Online]. Available through:
<http://www.bacpr.com/resources/15E_BACPR_Standards_FINAL.pdf>. [Accessed on
16th March 2016].
Cardiovascular disease. 2016. [Online]. Available through: <
https://www.camden.gov.uk/ccm/content/social-care-and-health/health-in-camden/joint-
strategic-needs-assessment-2012/chapter-14--cardiovascular-disease.en?page=1>.
[Accessed on 16th March 2016].
14 | P a g e

How important is this issue in Camden?. 2016. [Online]. Available through: <
https://www.camden.gov.uk/ccm/content/social-care-and-health/health-in-camden/joint-
strategic-needs-assessment-2012/chapter-14--cardiovascular-disease/?page=3>.
[Accessed on 16th March 2016].
What is the issue. 2016. [Online]. Available through: <
https://www.camden.gov.uk/ccm/content/social-care-and-health/health-in-camden/joint-
strategic-needs-assessment-2012/chapter-14--cardiovascular-disease.en?page=2>.
[Accessed on 16th March 2016].
Cardiovascular prevention research study, led by Camden CCG, opens at The Royal Free. 2014.
[Online]. Available through: < http://www.uclpartners.com/news/cardiovascular-
prevention-research-study-opens/>. [Accessed on 16th March 2016].
NICOR UCLP cardiovascular prevention research study. 2014. [Online]. Available through: <
https://www.ucl.ac.uk/nicor/nicor-news-publication/nicor-uclp-cardiovascular-
prevention-research-study>. [Accessed on 16th March 2016].
Epidemiology of Coronary Heart Disease. 2016. [Online]. Available through: <
http://patient.info/doctor/epidemiology-of-coronary-heart-disease>. [Accessed on 16th
March 2016].
15 | P a g e

16 | P a g e