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Reducing levels of premature deaths from heart disease and stroke

Overview

Health policy is devolved. This information applies to England.

Cardiovascular disease

Heart disease is commonly referred to as cardiovascular disease (CVD). CVD is a term used to describe any of several conditions that affect the functioning of the heart and blood vessels, making it more difficult for blood to flow freely through the body.

There are different types of CVD, including:

• coronary heart disease, when there is reduced or blocked flow of blood to the heart
• stroke, when blood supply to part of the brain is cut off
• peripheral arterial disease, when arteries to the limbs are blocked
• aortic disease, a group of conditions affecting the blood vessel that carries blood from the heart to the rest of the body

Several factors increase the risk of a person developing CVD, including:

• lifestyle – such as smoking, drinking too much alcohol, being overweight and not being active
• age – CVD mainly affects people over 50 years old
• sex – men are more likely to get CVD than women
• ethnicity – people may be more likely to get CVD if they're from a South Asian, Black African or African Caribbean ethnic background
• having family members with CVD
• having certain conditions, such as diabetes, high blood pressure or high cholesterol

There are different approaches to treating CVD, including medication, surgery or medical devices. Healthcare professionals may also encourage people to make lifestyle changes such as becoming more physically active or losing weight.

Premature deaths

According to NHS England, CVD is responsible for one in four premature deaths in the UK and accounts for the largest gap in healthy life expectancy. Those in the most deprived 10% of the population are almost twice as likely to die as a result of CVD than those in the least deprived 10% of the population.

The British Heart Foundation (BHF) has estimated that over 8 million people are living with CVD in the UK. It has also estimated that CVD causes 26% of all deaths in the UK, roughly 170,000 deaths each year.

The BHF has also estimated that around 70% of the UK’s cardiovascular burden is associated with modifiable risk factors – these are behaviours and exposures that affect a person’s risk of disease. Modifiable risk factors are often preventable.

The Parliamentary Office of Science and Technology has published a briefing, Geographical differences in healthy life expectancy, which explains modifiable risk factors in more detail.

Health trends for England and for local authorities on the Office for Health Improvement and Disparities Fingertips data website.

Health policy (England)

In England, the responsibility for public health is shared between different bodies. Public health services are commissioned at the local and national level:

• locally, by NHS integrated care boards (ICBs) and upper tier local authorities
• nationally, by NHS England and the Department of Health and Social Care (DHSC). The Office for Health Improvements and Disparities (OHID) is the arm’s-length body of the DHSC responsible for addressing health disparities.

Nationally commissioned services

NHS Health Check

During an NHS Health Check, healthcare professionals will check a person’s health in relation to their heart and blood vessels (cardiovascular health). The check will help to determine whether a person is at increased risk of developing heart disease, diabetes, kidney disease and stroke. The check is for people aged 40 to 74 who do not have pre-existing cardiovascular conditions; (people with these conditions will already be offered regular check-ups). People will be invited for an NHS Health Check once every five years.

The government has said it is developing a digital NHS Health Check, which will be ready for testing in early 2025 and would enable people to take a health check at home. It also said it is trialling heart health checks for people in workplaces to improve earlier diagnosis of CVD.

Core20PLUS5

Core20PLUS5 is an NHS England initiative which aims to reduce health inequalities nationally and locally. It provides a framework for identifying the groups which are at greatest risk of health problems and implementing measures to address these. ‘Core20’ refers to the most deprived 20% of the population in England, according to the Index of Multiple Deprivation (IMD). ‘PLUS’ refers to population groups that are at risk of poorer health outcomes but may fall outside the 20% captured by the deprivation measure. NHS England’s examples of these groups include minority ethnic communities, people with a learning disability or neurodivergence and people with long term health conditions. ‘5’ refers to five clinical areas where targeted measures would have a significant effect, one of which is interventions to optimise blood pressure and minimise the risk of heart attack and stroke.

Local health bodies, such as ICBs, are responsible for implementing Core20PLUS5 initiatives according to the needs of the local population.

Darzi report

In July 2024, Wes Streeting, the then Secretary of State for Health and Social Care, commissioned Lord Darzi to carry out an independent investigation into the NHS in England. The final report of the investigation (‘the Darzi report’) was published in September 2024. Lord Darzi ultimately concluded that the NHS is in “serious trouble” (page 1). Regarding CVD, the report said “care for cardiovascular conditions is going in the wrong direction” and that “rapid access to treatment had deteriorated” (page 5).

10-year health plan for England

In July 2025, the government published its 10 Year Health Plan for England.

The government set out plans to introduce a neighbourhood health service, which would “bring care into local communities”. Through this new service, the government said it would test new delivery models for secondary. These new ‘Prevention Accelerators’ would initially run in selected ICBs and would focus on community-led methods to address variation in uptake of high-impact cardiovascular disease and diabetes interventions.

The government said it would trial the use of genomic data alongside other risk factors to improve cardiovascular disease prevention through the Our Future Health programme. If successful, the approach will be expanded to all 5 million participants and could later be rolled out more widely for other conditions, including diabetes, breast, bowel and prostate cancer, and dementia.

2019 Long Term Plan

There is information on the NHS England website about CVD, including ongoing work to address it. Much of this relates to the 2019 NHS Long Term Plan ambitions to help prevent CVD (see Long Term Plan 2019, CVD).

NHS England’s 2019 Long Term Plan sets out actions that aim to help prevent up to 150,000 heart attacks, strokes, and dementia cases by 2029, and the government has said progress towards this is ongoing.

The government has explained that a CVD programme has been established. The programme is clinically led by national clinical directors and national speciality advisors. The programme is also supported by senior clinicians from cardiac and stroke specialities, and primary care, as part of expert advisory groups.

National Audit Office report 2024

In 2024, the National Audit Office published its report, Progress in preventing cardiovascular disease. The report noted that just 3% of local authorities had delivered a health check for all of their annual eligible population in 2023-24, and that less than half of the annual eligible population had attended a health check in the same year. The NAO made four recommendations, including that the DHSC review the commissioning model for NHS Health Checks, set clear national uptake targets, target delivery towards those at greatest risk of cardiovascular disease to reduce health inequalities, and improve data sharing across the health system to strengthen monitoring and evaluation of the programme.

The NAO’s recommendations tracker states that the DHSC has accepted the recommendations on reviewing commissioning arrangements and sharing data, and is considering those on uptake targets and target delivery towards those at high risk. The tracker also notes that work is in progress across the four recommendations.

Major conditions strategy

The previous Conservative government intended to publish a major conditions strategy, which would cover six conditions including cardiovascular disease. In August 2023, the government published the Major Conditions Strategy: case for change and our strategic framework. The development of this strategy was paused following the general election.

CVD Modern Services Framework

The government has said it is developing a new Cardiovascular Disease Modern Service Framework, which would support the adoption of evidence-based pathway improvements. The government said the framework would be published in Spring 2027, and would prioritise ambitious, evidence-led and clinically informed approaches to prevention, treatment and care.

Reading list

Lords Library, Cardiovascular disease: What is the government doing about England’s leading cause of premature death?, 3 June 2025

Commons Library, Prevention of cardiovascular disease, 6 February 2025

The Guardian, About 170,000 people in England expected to die from obesity-linked heart conditions by 2035, 29 June 2026

BBC News, Does two hours of strength training a week reduce the risk of dying early?, 3 June 2026

Office for Health Improvement & Disparities, Mortality profile: statistical commentary December 2025, 2 December 2025

The Kings Fund, How Integrated Care Systems Can Prevent Cardiovascular Disease, 16 July 2025

British Heart Foundation, Action now could avoid up to 11,000 CVD deaths a year by 2035, 6 September 2024

British Heart Foundation, Growing gap in early heart disease death rates between poorest and richest in England, 21 May 2024

Parliamentary questions

Strokes: Health Services (UIN 10343, 1 July 2026)

Asked: how withdrawal of funding for Integrated Stroke Delivery Networks aligns with the planned Cardiovascular Disease Modern Service Framework.

Answer: Responsibility for services is with NHS commissioners.

The NHS England’s National Stroke Service Model and the National Service Model for an Integrated Community Stroke Service aim to reduce inequalities.

The government has committed to a 25% reduction in premature death due to CVD and stroke. To this end, a new CVD Modern Service Framework will be published in 2026.

Cardiovascular Diseases: Health Services (UIN 12967, 29 June 2026)

Asked: If the upcoming Cardiovascular Disease Modern Service Framework will consider the impact of obesity and kidney disease on cardiovascular disease.

Answer: The upcoming Cardiovascular Disease Modern Service Framework will look at all evidence on a range of risk factors.

The NHS Health check programme detects people at risk of heart disease, stroke, type 2 diabetes, and kidney disease aged between 40 and 74 years old. These people are then referred to appropriate pathways.