Abstract

The National Service Framework (NSF) established coronary heart disease as a priority area for the government and for the National Health Service (NHS). In the three and a half years since its launch, good progress has been made and the NSF is already delivering real improvements for patients, demonstrated by a near 25% reduction in the death rate from circulatory diseases. Prescribing of cardiovascular drugs for secondary prevention has increased, acute myocardial infarction is being treated more promptly, and there is improved access to revascularisation procedures. However, there is still a notable class differential in cardiovascular deaths. There has been exponential growth in use of statins but the drugs are still not being used to optimum effect. Heart failure has now been identified as a priority for action.