Small changes in United Kingdom cardiovascular risk factors could halve coronary heart disease mortality

The U.K. government recently called for a 40% reduction in cardiovascular disease mortality by 2010. We examined the potential for cardiovascular risk factor changes to achieve that target.

We applied a previously validated mortality model, IMPACT, to an England and Wales population (37.1 million, aged 25-84). The model integrates information on trends in all the major cardiovascular risk factors, plus the uptake and effectiveness of all medical and surgical treatments. The potential reductions in coronary heart disease mortality from the base year, 2000, were calculated for two contrasting scenarios: (a) if recent risk factor trends simply continued to 2010 and (b) if further small reductions in risk factors were achieved, as in Scandinavia and the United States.

Continuation of recent risk factor trends should result in approximately 10,685 fewer coronary deaths in 2010 (minimum estimate 10,110; maximum 16,460) than in 2000. Modest additional reductions in cholesterol and smoking could potentially achieve 51,270 fewer deaths (minimum 39,435; maximum 71,510). Optimistic changes in obesity, diabetes, and physical activity, however, would have relatively small effects.

Modest additional risk factor reductions in cholesterol and smoking already achieved in the United States and Scandinavia could prevent or postpone > 50,000 deaths by 2010, halving current coronary mortality.