“Coronary heart disease (CHD), also called coronary artery disease (CAD), is when the vessels supplying blood and oxygen to your heart become narrow or constricted⑺”
The main causes are:
Smoking cigarettes – Cigarette smoking is a major cause of strokes. High blood pressure – Can put strain on your heart and can lead to CHD. High cholesterol levels – Cholesterol is essential for healthy cells, but if there is too much in the blood it can lead to CHD. Unhealthy diet – A bad diet can lead to diabetes, high cholesterol, hypertension and uncontrolled weight. Each of these factors independently contribute to a high risk of heart disease. Physical inactivity – Regular physical activity decreases the risk of coronary artery disease because it makes the coronary arteries wider and more flexible. Alcohol consumption – Raises blood pressure; puts more pressure on arteries. Obesity – Reduces HDL cholesterol which enable lipids to be transported within the water-based bloodstream.
The cost of coronary heart disease to society cannot be viewed in terms of just money, but also the loss of 166,000 lives every year, this figure is the number of people who died of coronary heart disease in 1961 in the UK. The figure in 1997 however had fallen to 140,500. In 2000, this figure had fallen still to 125,000, and in 2010 more than 65,000 people died from coronary heart disease; more than for any other disease⑹.
The total direct healthcare costs of coronary heart disease in 1999 came to £1.73 billion. The major costs were those used for hospital inpatient care, which accounted for £917 million (or 53% of the total) and drug treatment, which accounted for £558 million (or 32% of the total). Rehabilitation and community care, prevention and primary care, accident and emergency (A&E) and outpatient care accounted for 7.4%, 3.6%, and 2.9%, respectively, of total direct costs. People aged 65 years and above and men utilised 63% and 52% of total expenditure, respectively⑴. In 2006, coronary heart disease cost the UK NHS approximately £3.2 billion, this represents a cost per capita of just over £50 for each condition.
The cost of hospital care for people who have coronary heart diseases accounts for about 73% of these costs⑵. The hospital costs for stroke account for 94% of the total health care costs⑶. In 2006 the total cost of coronary heart disease to the UK economy was approximately £9.0 billion⑸. Some patients with coronary heart disease will be referred for cardiac rehabilitation, particularly following bypass surgery or if they have experienced angina or a heart attack. The rehabilitation may consist of an exercise plan to help regain stamina safely based on individual ability and needs, and education, counseling, and training. Training may include ways to better manage stress, as well as how to manage other lifestyle factors that contribute to coronary heart disease.
An estimated 401 000 people provided informal care to coronary heart disease patients in the UK and about 408 million hours were used to care for them. Informal care of coronary heart disease sufferers was estimated to cost £2.42 billion⑴. About 150 565 working years were lost from deaths from coronary heart disease in England and Wales; 71% of these working years lost were from deaths in men in the 45–64 year age range⑴. There were 65.4 million working days lost because of incapacity resulting from coronary heart disease in the UK. In 2004, the average length of stay for an individual entering the hospital for CHD complications was 4.3 days⑴.
To the UK population, an estimated 765 000 men and 698 000 women had experienced a coronary heart disease event in the past year, with those aged 55 and above accounting for 88% of cases, also to the UK population, an estimated 1.42 million men and 1.14 million women have a history of doctor diagnosed coronary heart disease⑷. In 2006 over 2.2 million people were living with CHD; 1.3 million men and 860,000 women⑸.
The mortality cost of coronary heart disease in the UK was estimated to be about £1.81 billion (of which £1.68 billion can be attributed to men and £0.123 billion to women)⑴. The total cost of illness associated with coronary heart disease in the UK is £7.06 billion per year⑷.
CHD, by itself, is the most common cause of premature death in the UK. About one fifth (18%) of premature deaths in men and one in ten (9%) premature deaths in women from CHD, which caused over 28,000 premature deaths in the UK in 2008⑶. Rates of CHD are higher in men than in women and rates increase with age. However CHD is also a major cause of premature (under 75) deaths. In 2010, there were over 21,000 premature deaths from CHD in England⑸.
CHD rates are not distributed evenly around England. Death rates are much higher in the North of England compared to the South. Premature mortality rates in the North West are about 50% higher than in the South East for men, and 60% higher for women. But CHD rates in England are lower than in the rest of the UK⑸. Approximately 85% of those who die of coronary artery disease are age 65 or older⑽.
People that are diagnosed with coronary heart disease may feel worried or anxious about their personal well being and how this diagnosis will affect their lifestyle⑻. Patients diagnosed with heart disease may experience guilty feelings. They may believe that their chosen lifestyles may have contributed to them acquiring coronary heart disease⑻. Patients with coronary heart disease may isolate themselves socially from their friends as a result of side effects of their medications or symptoms of their disease, such as fatigue⑻.
Depression is a condition that patients with coronary heart disease may experience. This may be caused by a variety of reasons. They may become less motivated and less functional in their roles in life; achieving goals and getting jobs⑻. Depression is strongly correlated with the presence of angina within a patients with coronary heart disease. Also patients with physical health problems such as coronary heart disease often have worse quality of life⑼.
In conclusion, the cost of coronary heart disease to society are the mass amount of people lost to this disease every year, the pain that the relatives and friends endure and the economic burden from the cost of all the healthcare and time invested to help those in need.