Missing, mediocre, or merely obsolete? An evaluation of UK data sources for coronary heart disease

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Abstract
Study objective: Coronary heart disease (CHD) is the commonest cause of death in the UK. However, there is no single comprehensive source of information to support CHD prevention and treatment strategies. Therefore this study evaluated the availability and quality of UK CHD data sources since 1981. Design: Data sources for England and Wales were identified and appraised on: (1) CHD patient numbers (myocardial infarction, angina, hypertension, and heart failure); (2) uptake of medical and surgical CHD treatments, and (3) population trends in major cardiovascular risk factors. Setting: England and Wales (population 53 million). Main results: Population and mortality data were easily accessible from Office for National Statistics and British Heart Foundation Annual CHD Statistics; population based risk factor data came principally from the British Regional Heart Study, the General Household Survey, and the Health Survey for England. They were limited for 1981, but more extensive by 2000. Hospital admissions information since 1998 was available online from HES; but trend data and details of interventions were scant. Limited primary care data on consultation rates, prescribing, and treatment uptake were available from published audits and studies. Conclusions: Information on CHD in the UK is fragmented, patchy, and mixed in quality. Data for women, the elderly populatiom, and ethnic minorities were particularly scarce, exacerbating inequalities. Future CHD disease monitoring and evaluation will require comprehensive and accurate population based information on trends in patient numbers, treatment uptake, and risk factors.