Coronary heart disease: policy context

From their peak in the 1970s, incidence rates of coronary heart disease (CHD) have declined steadily in Scotland, but not at the pace of neighbouring northern European countries. CHD will remain a major public health problem in Scotland for several decades to come.

A target of a 50% reduction between 1995 and 2010 in the age-standardised death rate from CHD for people aged under 75 was set in the 1999 white paper Towards a healthier Scotland. The Scottish Executive has recently increased this target to a 60% reduction (see section Data: Scottish data).

In light of Scotland's poor record on heart disease and stroke, the Scottish Executive published the CHD and stroke strategy for Scotland in October 2002, following the publication of the CHD/Stroke Task Force report a year earlier. The strategy represents the culmination of 4 years' work, based upon extensive consultation with patients, clinicians and managers.

Progress of the strategy was reviewed in a supplementary report, Coronary heart disease and stroke in Scotland - Strategy update 2004, published in December 2004.

One of the strategy recommendations was for all health boards to have managed clinical networks (MCNs) for CHD services, and these have now been established. Further information on CHD MCNs can be found on the Scottish Executive's website under CHD.

In relation to inequalities, national targets for improving the trend in reducing premature CHD mortality in deprived areas are in place through the Closing the opportunity gap strategy. These are also included within the Scottish Executive's 2005-2008 spending proposals.

There have been a number of SIGN guidelines on CHD and stroke, and Guideline 97 'Risk estimation and the prevention of cardiovascular disease' was published in February 2007.