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Incidence and prevalence of cardiovascular disease in English primary care: a cross-sectional and follow-up study of the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC)
  1. William Hinton1,
  2. Andrew McGovern1,
  3. Rachel Coyle1,
  4. Thang S Han1,2,3,
  5. Pankaj Sharma1,2,
  6. Ana Correa1,4,
  7. Filipa Ferreira1,
  8. Simon de Lusignan1,4
  1. 1 Section of Clinical Medicine & Ageing, Department of Clinical & Experimental Medicine, University of Surrey, Guildford, UK
  2. 2 Institute of Cardiovascular Research, Royal Holloway University of London, Egham, UK
  3. 3 Department of Endocrinology, Ashford and St Peter’s NHS Foundation Trust, Chertsey, UK
  4. 4 Royal College of General Practitioners, Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC), London, UK
  1. Correspondence to Professor Simon de Lusignan; s.lusignan{at}surrey.ac.uk

Abstract

Objectives To describe incidence and prevalence of cardiovascular disease (CVD), its risk factors, medication prescribed to treat CVD and predictors of CVD within a nationally representative dataset.

Design Cross-sectional study of adults with and without CVD.

Setting The Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) is an English primary care sentinel network. RCGP RSC is over 50 years old and one of the oldest in Europe. Practices receive feedback about data quality. This database is primarily used to conduct surveillance and research into influenza, infections and vaccine effectiveness but is also a rich resource for the study of non-communicable disease (NCD). The RCGP RSC network comprised 164 practices at the time of study.

Results Data were extracted from the records of 1 275 174 adults. Approximately a fifth (21.3%; 95% CI 21.2% to 21.4%) had CVD (myocardial infarction (MI), angina, atrial fibrillation (AF), peripheral arterial disease, stroke/transient ischaemic attack (TIA), congestive cardiac failure) or hypertension. Smoking, unsafe alcohol consumption and obesity were more common among people with CVD. Angiotensin system modulating drugs, 3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA) reductase inhibitors (statins) and calcium channel blockers were the most commonly prescribed CVD medications. Age-adjusted and gender-adjusted annual incidence for AF was 28.2/10 000 (95% CI 27.8 to 28.7); stroke/TIA 17.1/10 000 (95% CI 16.8 to 17.5) and MI 9.8/10 000 (95% CI 9.5 to 10.0). Logistic regression analyses confirmed established CVD risk factors were associated with CVD in the RCGP RSC network dataset.

Conclusions The RCGP RSC database provides comprehensive information on risk factors, medical diagnosis, physiological measurements and prescription history that could be used in CVD research or pharmacoepidemiology. With the exception of MI, the prevalence of CVDs was higher than in other national data, possibly reflecting data quality. RCGP RSC is an underused resource for research into NCDs and their management and welcomes collaborative opportunities.

  • cardiac epidemiology
  • primary care
  • epidemiology
  • health informatics

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors WH led the analysis and drafting of the paper. AM and AC supported the statistical analysis of the paper. SdL led the development of the cohort, conceived the idea and contributed to the drafting of the paper. RC, TSH, PS and FF also contributed to the preparation and reviewing of the manuscript.

  • Funding This study was funded internally by the Department of Clinical and Experimental Medicine at the University of Surrey.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The RCGP RSC data set can be accessed by researchers, approval is on a project-by-project basis (www.rcgp.org.uk/rsc). Ethical approval by an NHS Research Ethics Committee is needed before any data release/other appropriate approval. Researchers wishing to directly analyse the patient-level pseudonymised data will be required to complete information governance training and work on the data from the secure servers at the University of Surrey. Patient-level data cannot be taken out of the secure network. We encourage interested researchers to attend the short courses on how to analyse primary care data/RCGP RSC data offered twice a year.

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