Director of Public Health Annual Report 2022: Preventing heart disease and stroke in Buckinghamshire

Buckinghamshire adults in Buckinghamshire CCG. 80% of current smokers, 89% of patients with a diagnosis of high blood pressure and 91% of patients with either diabetes, coronary heart disease or stroke/TIA have their ethnicity recorded.

The three ethnic groups with the highest prevalence of coronary heart disease are Pakistani (4.7%), white British (4.1%) and ‘Other’ ethnicity (3.3%). The three ethnic groups with the highest prevalence of stroke/TIA are white British (2.4%), Other (1.8%) and Pakistani (1.6%).

It appears that different risk factors may be at play for these ethnic groups. For example, the Pakistani population have the highest prevalence of diabetes (14%), but below average prevalence of recorded high blood pressure (12%). In comparison, the white British population has the highest recorded prevalence of high blood pressure (19%), but below average diabetes (6%). Overall, the prevalence of coronary heart disease is recorded as being highest in the Pakistani (4.7%) and white British (4.1%) ethnicities. Stroke/TIA is highest in the white British (2.4%) ethnicity.

The prevalence of coronary heart disease is lowest in black groups (1.7%) and people from the mixed ethnic group (1.9%). However, these data do not take age into account so given that these are conditions increase with age some of the difference may be explained by differences in the age of these ethnic groups.

To enable sufficient numbers for analysis, three years of admissions data have been pooled (2018/19 to 2020/21).

Ethnicity was known for 84% of emergency cardiovascular disease admissions during this period. For emergency cardiovascular disease admissions when an ethnicity was recorded, 84% in Buckinghamshire were white British, which is in line with 81% of the population being listed as white British in Buckinghamshire at the last Census in 2011.

Ethnicity was known for a lower proportion of elective cardiovascular disease admissions at 76%, compared to 84% for emergency cardiovascular disease admissions. The proportion of cardiovascular disease admissions being for white British patients (of those with an ethnicity recorded) was 85%. We are awaiting more recent data from the 2021 census to update our analysis comparing admission rates for different ethnic groups. There appears to be over-recording of individuals having ‘Other’ ethnicity in Buckinghamshire hospital data. 2% of emergency cardiovascular disease admissions and 1.6% of elective cardiovascular disease admissions were recorded as being for patients of ‘Other’ ethnicity in comparison to representing 0.5% of the population at the last Census.

Conversely, there appears to be under-recording of individuals having ‘Mixed’ ethnicity in Buckinghamshire hospital data. 0.5% of emergency cardiovascular disease admissions and 0.6% of elective cardiovascular disease admissions were recorded as being for patients of ‘Mixed’ ethnicity in comparison to representing 2.4% of the population at the last Census. This could suggest that some individuals who are recorded on the Census as being of Mixed ethnicity are being recorded as ‘Other’ ethnicity by acute NHS Trusts for Buckinghamshire residents.