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14-11-2010 | General practice | Article

Regional variations in CHD mortality persist


JAMA 2010; 304: 2028–2034

MedWire News: Marked regional variations in coronary heart disease (CHD) mortality rates across England are primarily due to differences in population characteristics, UK researchers report.

They found that areas with high proportions of White individuals and smokers, and high levels of diabetes and socioeconomic deprivation were associated with high levels of CHD mortality at Primary Care Trust (PCT) level, while successful detection of high blood pressure by primary care services was associated with reduced levels of CHD mortality.

A national policy was launched in 2000 to reduce the CHD mortality rate by two-fifths in individuals younger than 75 years of age by 2010.

"This goal was achieved nationally, but regional variations in CHD mortality rates persist," notes the team in JAMA.

Louis Levene, from the University of Leicester, and colleagues assessed age-standardized CHD mortality rates in all 152 PCTs in England in 2006, 2007 and 2008. They report that the mean overall CHD mortality rate fell over the 3-year period, from 97.9 to 88.4 CHD-related deaths per 100,000 European Standard Population.

Wide variations in CHD mortality rates existed across the different PCTs, with the highest rates found in the Blackburn and Tameside PCTs in 2007 and 2008, respectively, and lowest rates in the Kensington and Chelsea PCT throughout the 3 years.

Levene and colleagues conclude: "A population orientation may be important in promoting further declines in CHD mortality rates.

"The extent to which primary health care services can affect these population factors is not certain."

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Caroline Price