Cardiovascular disease: What is the government doing about England’s leading cause of premature death?

Approximate read time: 10 minutes

On 12 June 2025, the House of Lords will debate the following question for short debate:

Lord Booth (Conservative) to ask His Majesty’s Government what plans they have to improve the detection, prevention and treatment of cardiovascular illness.

1. What is cardiovascular disease?

Cardiovascular disease (CVD) is a general term for a group of disorders of the heart and blood vessels. It is the leading cause of death globally.^[1]

CVD includes conditions that narrow or block blood vessels, which can lead to heart attacks, angina and some strokes.^[2]

In some cases, CVD is congenital (a defect present from birth) or caused by infection. There are also increased risks for people with diabetes, kidney disease or a family history of CVD, as well as for people of South Asian and Black African or Caribbean background.^[3]

The most common risk factors for CVD are environmental and behavioural, including:^[4]

• smoking
• diet and weight
• physical inactivity
• excess alcohol consumption
• air pollution

High blood pressure and high cholesterol are risk factors. Risk increases with age, and men tend to get CVD at a younger age than women.^[5]

2. What is the prevalence of cardiovascular disease?

According to NHS figures, CVD affects over seven million people in the UK. It is responsible for one in four premature deaths (deaths occurring under the age of 75).^[6]

In the latest data, from 2023, people in the most deprived 10% of the population were almost twice as likely to die prematurely from CVD than those in the least deprived 10%.^[7]

Figure 1 shows the number of people under 75 years old who died as a result of CVD from 2001 to 2023. The numbers decreased from 145.2 per 100,000 people in 2001 to a low of 69.1 in 2019.^[8] Rates then increased to 77.8 in 2022, and dipped to 77.4 in 2023.

Figure 1. Number of people per 100,000 who died under the age of 75 from cardiovascular disease

The King’s Fund has assessed that the fall in the number of deaths was attributable to a decrease in risk factors, notably falling smoking rates, and medical advances in prevention and management.^[9] Rates began to rise again during the Covid-19 pandemic.^[10]

In 2023/24, there were 218,606 hospital admissions for coronary heart disease and 111,137 admissions for stroke in England.^[11] The government has assessed that CVD costs the NHS an estimated £10bn and the economy an estimated £24bn a year.^[12]

3. What did previous governments do about cardiovascular disease?

The then Conservative government’s 2019 NHS long term plan identified CVD as a priority for improved care and outcomes.^[13] The plan stated it was “the single biggest area where the NHS can save lives over the next 10 years”.^[14] The government set a goal to “help prevent up to 150,000 heart attacks, strokes and dementia cases over the next 10 years”.^[15]

NHS England has said it had been working on a range of measures following the plan, including:^[16]

• improving and increasing early detection and treatment, through patients routinely knowing their ‘ABC’ numbers: atrial fibrillation (irregularities in heart rate), blood pressure and cholesterol
• increasing diagnostic testing and genetic testing
• improving the response of the public to someone having a cardiac arrest and expanding the defibrillator network
• auditing records to identify people at risk of developing CVD through the ‘CVD Prevent’ programme
• increasing the proportion of patients with heart failure and heart valve disease who complete a course of cardiac rehabilitation

The government also highlighted NHS health checks, initially established in 2009, which are commissioned by each local authority.^[17] People aged 40 to 74 without certain pre-existing conditions should be invited every five years for an appointment to check risk factors including blood pressure, cholesterol, BMI and lifestyle.^[18]

The government reviewed the programme in 2021. It said it would work towards digital health checks, as well as funding a pilot to deliver cardiovascular checks in workplaces.^[19]

The then government also said it would introduce a ‘Major conditions’ strategy, with cardiovascular disease as one of six major health conditions which form the strategy’s focus.^[20] The government did not introduce the strategy before the general election and the new government has said that work on it is paused.

4. What are the current government’s plans for tackling cardiovascular disease?

In its manifesto, Labour said it would “deliver a renewed drive to tackle the biggest killers; cutting the lives lost to cancer, cardiovascular disease and suicide”.^[21]

In July 2024, the new Labour government commissioned Lord Darzi (non-affiliated) to do an independent investigation into the state of the NHS in England.^[22] Lord Darzi concluded that the NHS was “in serious trouble”.^[23] He said that cardiovascular care was “going in the wrong direction”, with rapid access to care for heart attacks and strokes deteriorating.^[24] The report also highlighted health inequalities, both in mortality rates and take up of rehabilitation programmes.^[25]

Following the report and a public engagement exercise, the government is developing a new 10-year plan.^[26] Linking the plan to tackle CVD, the government said:

The 10-year health plan will deliver the three big shifts the National Health Service needs to be fit for the future: from hospital to community, from analogue to digital, and from sickness to prevention. All three shifts are relevant to improving outcomes for those experiencing heart attacks or strokes. More tests and scans delivered in the community, better joint working between services, and greater use of apps and wearable technology will all help people manage their conditions closer to home and help to reduce hospital admissions.^[27]

The government has said its aim is to reduce premature deaths from heart disease and strokes by 25% within 10 years.^[28]

It has set out a number of ways it aims to tackle the issue. For example, answering a written question about cardiovascular disease, the government said funding in the autumn 2024 budget would support the NHS to provide more diagnostic scanners and tests, appointments and operations.^[29] In addition, in its January 2025 ‘Elective care reform’ plan, NHS England said it aimed to reduce the number of unnecessary diagnostics by introducing specialist input earlier in care pathways and developing standard pathways for common outpatient presentations.^[30]

The government has said that it supports the health check programme, and is working on the delivery of digital health checks and health checks in workplaces.^[31]

The government has also highlighted preventative policies, including:^[32]

• implementing advertising regulations for less healthy food and drink
• empowering councils to block the development of new fast-food shops outside schools
• measures in the Tobacco and Vapes Bill^[33]

5. What have other stakeholders said?

In November 2024, the National Audit Office (NAO) published a report on ‘Progress in preventing cardiovascular disease’. The NAO concluded that while health checks had the potential to deliver value for money, there was “no effective system” for commissioning them and local government had “weak levers” to encourage primary care and other providers to deliver them. It said under half of the annual eligible population attended a health check in 2023/24.

The NAO recommended that the government:

• review how health checks are commissioned, and consider incentives for primary care practitioners to deliver them
• set clear targets for population reach
• incentivise delivery of health checks to the most at-risk groups
• work on data improvements, including whether health check data could be added to the CVD Prevent audit data

The British Heart Foundation has raised concerns about long waiting lists for cardiovascular appointments and slower ambulance response times.^[34]  It has called for investment in prevention and research, improved care, and a dedicated plan to tackle CVD.^[35]

An earlier 2022 report from the King’s Fund also called for a “comprehensive” national strategy.^[36] It emphasised action to address workforce shortages and shorten waiting times was “critical” to save more lives.

6. Read more

• Department of Health and Social Care, ‘Public health data: Cardiovascular disease 2023/24’, accessed 29 May 2025
• Debate on ‘Cardiovascular disease: Prevention’, HC Hansard, 13 February 2025, cols 232WH–252WH
• House of Commons Health and Social Care Committee, ‘Oral evidence: Progress in preventing cardiovascular disease’, 22 January 2025, HC 561 of session 2024–25
• British Heart Foundation, ‘Heart and circulatory disease UK factsheet’, January 2025
• Nathalie Conrad et al, ‘Trends in cardiovascular disease incidence among 22 million people in the UK over 20 years: Population based study’, British Medical Journal, 26 June 2024, no 385

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Image by estableman from Pixabay