Cerebrovascular diseases (CVBD)

Cerebrovascular Disease (CBVD), is the death of brain tissue that occurs when the brain does not receive enough blood flow and oxygen.  It is the third largest killer and a major cause of hospital admission in Herefordshire.  Stroke is one of the most common types of cerebrovascular disease, and accounts for around two of every five CVD-related deaths in Herefordshire.

This page contains key facts and figures about CBVD in Herefordshire: prevalence; hospital admissions, mortality and causes and preventative interventions.  More detailed reports can be downloaded at the bottom of the page.

Key issues:
  • The rate of deaths related to stroke has fallen more rapidly in Herefordshire than in England as a whole over recent years, but deaths from stroke remain higher than nationally;
  • In Herefordshire, physical inactivity is responsible for more strokes than both hypercholesterolemia and hypertension, whilst obesity is responsible for more than hypertension.

Prevalence1 of CBVD

The GP-recorded prevalence of both stroke and hypertension (which is a risk factor for stroke) are both significantly2 higher in Herefordshire than in England as a whole.

In 2009/10, stroke prevalence amongst patients registered with a Herefordshire GP was 2.2%, compared to 1.7% nationally.  Of all Herefordshire patients, 15.4% were recorded as having high blood pressure, compared to13.4% nationally.  However, these prevalence rates do not take account of any differences in the age structure of the registered population.

Modelled estimates produced by the Eastern Region Public Health Observatory (which do take account of age structure) indicate that actual prevalence is higher than GP records suggest.  Taking account of various characteristics of the population it is estimated that 96% of Herefordshire stroke prevalence was recorded by GPs in 2008/09, but only 54% of hypertension prevalence. 

For more details about the prevalence of CVBD, including differences between GP surgeries in Herefordshire, see the full Cerebrovascular Diseases report below.

CBVD-related hospital admissions

There were 630 cerebrovascular disease-related hospital admissions in 2009/10, with 60% of admissions relating to those aged 75 years and over.  Hospital admissions due to CBVD have increased by almost 10% between 2005/06 and 2009/10 in Herefordshire, and county residents are 20% more likely to be admitted to hospital due to a cerebrovascular disease compared to the standard population of England.  There is no discernible association of hospital admission rates due to CVD with deprivation in Herefordshire.

For more details about hospital admissions due to CVBD, including analysis by age-group, see the full Cerebrovascular Diseases report below.

Mortality rates from CBVD

Cerebrovascular disease is the 3rd largest cause of mortality in Herefordshire, and accounts for approximately 230 deaths per year.  Around 40% of CVD-related mortality in the county is accounted for by stroke.

Herefordshire has achieved a 35% reduction in stroke mortality rates between 1995-97 and 2007-09, although rates remain significantly higher than national and comparator PCT rates, and in fact rose slightly in the latest three-year period 2007-09.  People in Herefordshire are approximately 24% more likely to die of stroke than is the case in England overall.

Considering mortality at any age from all cerebrovascular diseases, there does not appear to be any association with deprivation in Herefordshire.  However, people living in the most deprived4 quartile of the county are 78% more likely to die prematurely (under 75 years) from cerebrovascular disease than a resident of the least deprived quartile (although this difference is not statistically significant). 

For more details about deaths from CVBD, including more detailed trend analysis, see the full Cerebrovascular Diseases report below.

Causes of stroke in Herefordshire and the impact of preventative interventions

A study was carried out by the Public Health Department in July 2011 to identify the proportion of disease in the local population due to particular risk factors for stroke, and the impact of preventative interventions in reducing the number of stroke events3Hypertension and hypercholesterolemia are well recognised and treated risk factors for stroke. However, the study found that physical inactivity causes more strokes than hypercholesterolemia and hypertension, and obesity causes more strokes then hypertension. The overall conclusion is that physical inactivity and obesity are significant causes of strokes in Herefordshire.  

The full technical report, which includes analysis of the potential impacts of preventative interventions, can be downloaded below.

1 Prevalence is based on people registered with GPs in Herefordshire - regardless of whether they live in the county.  There may also be people with CVBD living in Herefordshire but registered with a GP elsewhere.
2 Significantly – means statistically significant as shown by the confidence intervals.  For more information about this see the information on confidence intervals on the useful definitions page.
3 Includes deaths and non-fatal episodes.
4 Based on the Index of Multiple Deprivation 2007. 

Cerebrovascular disease data resources

  • File (284.07kb)Cardiovascular disease in Herefordshire (July 2011)
  • A report from the Public Health Department about the prevalence of CVD in Herefordshire; hospital admissions; mortality. Including analysis of years of life lost and inequality within the county.
  • 284 kb

Last updated: 06 June 2012