Glossary of terms used in the cardiovascular disease profiles
Acute myocardial infarction (AMI)
Angiography
Clinical term for heart attack.
An investigative procedure in which a fine catheter is inserted via a blood
vessel to inject x-ray opaque dye into the coronary arteries to obtain an x-ray
image of the anatomy of the coronary arteries.
Angioplasty
A treatment to improve the blood supply through an artery. A catheter (a fine,
hollow tube) with a small inflatable balloon at its tip is inserted into a vein in
the groin and passed through tot the narrowed artery. The balloon is then
gently inflated so that it squashes the fatty tissue responsible for the
narrowing, and widens the artery.
Irregular electrical activity in the receiving chambers of the heart, leading to
irregular contraction of the heart muscle.
For men if they had consumed 8 or more units of alcohol on the heaviest
drinking day in the previous seven days; for women if they had consumed 6 or
more units of alcohol on the heaviest drinking day in the previous seven days.
The collective term for all diseases affecting the circulatory system (heart,
arteries, blood vessels). Commonly known as CVD, cardiovascular disease
includes heart disease (about 50%), stroke (about 25%), and all other diseases
of the circulatory system.
Cerebrovascular diseases are conditions that develop as a result of problems
with the blood vessels inside the brain.
A statistical tool for indicating the accuracy of an estimated figure. It can
reasonably be assumed that the true value lies somewhere within the
confidence interval. Normally 95% confidence intervals are used therefore
there is a 5% chance that the true value lies outside the confidence interval.
Estimates based on small numbers of cases are less accurate and will hence
tend to have wide confidence intervals.
An operation to bypass a narrowed section or sections of coronary arteries
and improve the blood supply to the heart.
CHD occurs when the walls of the coronary arteries become narrowed by a
gradual build-up of fatty material called atheroma. The two main forms of
CHD are heart attack (also known as myocardial infarction) and angina.
Directly age-standardised rates are the rates of events that would occur in a
standard population, eg European Standard Population, if that population
were to experience the age-specific rates of the observed population eg LA
population.
Admissions to hospital that are not planned.
Using the categories used in the 2001 Census, Black includes the groups Black
Caribbean, Black African & Black Other; Asian includes the categories Indian,
Pakistani, Bangladeshi & Other Asian; Other includes all other ethnic groups,
included mixed except British White.
Exceptions relate to patients who are on a GP disease register, and who would
ordinarily be included in a QOF indicator denominator. However they are
excepted from the indicator denominator because they meet at least one of
the QOF exception criteria eg patient does not attend for review, or a
medication cannot be prescribed due to a contraindication or side effect.
The GLF collects information on a range of topics from people living in private
households in Great Britain and samples approximately 9,000 responding
households per annum.
A series of annual surveys designed to measure health and health related
behaviours in adults and children, in England.
Atrial fibrillation
Binge drinking
Cardiovascular disease (CVD)
Cerebrovascular disease
Confidence interval
Coronary artery bypass graft (CABG)
Coronary heart disease (CHD)
Directly standardised rates (DSR)
Emergency admissions
Ethnicity
Exception reporting in QOF
General Lifestyle Survey
Health Survey for England
Heart failure
Heart failure is a clinical syndrome that occurs when the heart is unable to
pump enough blood to meet the demands of the body. It occurs because the
heart muscle is damaged or overworked. The ‘failing heart’ keeps working but
not as well as it should. Some people with mild heart failure may have very
few symptoms. People with moderate or severe heart failure suffer from a
number of problems, including shortness of breath, general tiredness and
swelling of the feet and ankles.
Hospital Episode Statistics (HES)
A data warehouse that contains information on patients admitted to hospitals
and outpatient attendances accross England.
Hypertension
High blood pressure. Hypertension happens if the walls of the larger arteries
lose their natural elasticity and become rigid, and the smaller vessels
constrict.
Index of Multiple Deprivation (IMD
This is a measure of multiple deprivation, based on the model of distinct
2010)
dimensions or domains of deprivation eg employment, income, health &
disability, which can be recognised and measured separately. There are 7
domains of deprivation in the IMD 2010, which can be experienced by
individuals living in an area.
Increasing risk and higher risk drinking (a) Increasing risk drinking is defined as usual consumption of between 22 and
50 units of alcohol per week for males, and between 15 and 35 units of
alcohol per week for females.
(b) Higher risk drinking is defined as usual consumption of over 50 units of
alcohol per week for males, and over 35 units of alcohol per week for females.
Indirectly standardised rate (ISR)
Indirect standardisation is used to calculate the expected rate for the local
area population, given age specific event rates from a reference population
(e.g. England & Wales)
The Integrated Household Survey (IHS) The Integrated Household Survey (IHS) was designed to be representative of
the general, non-institutional population living in England. The sample size of
the IHS for April 2010 to March 2011 on which the smoking prevalence
comprises more than 250,000 adults aged 18 and over.
Myocardial Ischaemia National Audit A project established in 1999 to allow hospitals to measure their performance
Project (MINAP)
against national standards and targets for the care of heart attack patients.
National Centre for Health Outcomes
Development (NCHOD)
Non-elective admissions
Obesity in adults
Office for National Statistics (ONS)
Primary angioplasty
Quality and Outcomes Framework
(QOF)
NCHOD is a unique national resource concerned with all aspects of health
outcomes assessment. One of its main activities is the production of
comparative health outcome indicators using available routine data; in the
form of the Compendium of Clinical and Health Indicators.
Admissions to hospital that are not planned, as well as transfers from other
hospitals that are not considered an emergency.
Where body mass index (weight in kg divided by the square of height in
metres) in adults, exceeds 30.
The government department that provides statistical and registration services,
and is responsible for producing a wide range of key economic and social
statistics.
Angioplasty is a procedure where an artery is re-opened mechanically using a
balloon catheter inserted into the blocked artery. Primary angioplasty refers
to using this treatment to increase blood flow to the heart in the early stages
of that heart attack and is one of the recommended treatments for those
diagnosed with STEMI. The effectiveness of primary angioplasty is time
dependent.
QOF is part of the General Medical Services contract for general practices,
introduced on 1 April 2004. The QOF provides financial rewards to general
practices for the provision of high quality care. It is intended to benefit both
patients and the NHS. The QOF measures achievement against a scorecard of
146 indicators, pus three measures of depth of care. GP practices score points
on the basis of achievement against each indicator. The QOF is made up of
four domains: clinical; organisational; patient experience; and additional
services.
Relative gap
Revascularisation
Smoking
Smoking quitters
ST elevated Myocardial Infarction
(STEMI)
Stroke
Modelled lifstyle estimates
The relative gap is the percentage difference between the indicator value in
the observed group and that in a reference group. This is a measure of
differenc between the two groups.
Procedures to restore blood flow through blocked coronary arteries. The two
most widely used techniques are coronary artery bypass graft surgery (CABG)
and percutaneous transluminal coronary angioplasty (PTCA). PTCA can also be
referred to as Percutaneous coronary intervention (PCI).
Those reporting they were a “current cigarette smoker” in the Integrated
Household Survey for England is the general definition of 'smoker'.
Number of smokers treated by a NHS Stop Smoking Service who self-report
continuous abstinence from smoking from day 14 post-quit date to the fourweek follow-up point.
This is a severe form of heart attack, caused by a prolonged period of blocked
blood supply. It affects a large area of the heart muscle, and so causes
changes on the ECG as well as in blood levels of key chemical markers. Either
thrombolysis or primary angioplasty are recommended as early treatments of
this condition.
A stroke is the consequence of an interruption to the flow of blood to the
brain. A stroke can vary in severity from a passing weakness or tingling of a
limb to a profound paralysis, coma and death.
Statistical modelling was used to produce estimates of lifestyle behaviours for
local authorities because the annual sample size of national surveys is too
small below ta certain level to provide reliable estimates. The model-based
estimate for a particular LA is the expected prevalence or behaviour (high risk
drinking and obesity) for that area based on its population characteristics (as
measured by other data) and as such does not represent an estimate of the
actual behaviour for the LA.