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Discuss the division of resources with regards to the prevention and treatment of CHDs:

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Introduction

Discuss the division of resources with regards to the prevention and treatment of CHDs: Although the rate of death from coronary heart disease in the UK continues to fall significantly each year, only Finland and Ireland have a higher death rate from CHD among developed countries. Being the nation's biggest killer it is unsurprising that millions of pounds are spent each year on the treatment and prevention of CHD. In this essay I aim to discuss and evaluate how resources should be divided with regards to the prevention and treatment of CHD and the various conditions associated with it. CHD is the disease of the two coronary arteries supplying the heart muscles with oxygenated blood and nutrients. CHD causes damage to these arteries by blocking the lumen of the vessels with plaques which leads to irreversible damage to the heart as the oxygen supply to the heart becomes either blocked or reduced casing the heart tissue becomes oxygen starved. The consequence of this is that part of the heart becomes deprived of oxygen and therefore dies unless an interconnecting blood vessel can take over the supply. If there is only a small blockage and the oxygen supply is reduced, the heart muscle is forced to respire anaerobically, therefore producing a painful build up of lactic acid. This is known as angina, and is the most common form of CHD and affects and an estimated 2 million people currently in the UK. Angina is largely a chronic condition, this causes a huge burden on the NHS as its treatment is ongoing and large amounts of money must be constantly spent on treating the condition. The NHS spends millions of pounds on treating CHD every year; this is made up of everything from expensive drugs to treat angina through to hospital stays for by-pass operations. Added to this are the millions of pounds lost to the economy from people taking time off work through ill health. ...read more.

Middle

One of the most recent breakthroughs in CHD is the increasingly common use of statins and other cholesterol lowering drugs. Prescriptions of these drugs went up by nearly a third between 2000 and 2001, with over one million prescriptions dispensed in England every month. Cholesterol lowering drugs alone saw the NHS drug treatment bill rise by 22% and now cost the NHS more than any other class of drug with over �440 million spent in 2001 (an increase of �113 million since 2000). There has also been an increase in the number of treatments taking place which will also add extra burden on the NHS budget. Revascularisation procedures have more than doubled in the past 10 years and the number of angioplasties has risen by nearly 40% in the past year to 39,000. Many of these treatment programs are ongoing and are relatively common which means they cost the NHS millions of pounds a year, and, the more effective they are, the longer the sufferer survives so the more drugs and therefore money is needed. The number of people at risk could become an increasing burden upon the NHS, creating a strong argument for the need of more money to be spent on preventative measures. There are two types of prevention; primary prevention and secondary prevention. Primary prevention is the use of healthy lifestyle education, preventative drugs or procedures before the patient has exhibited any signs of suffering from a CHD. This form of treatment can include the aforementioned statins and other cholesterol and lipid lowering drugs, these are at a cost to the NHS and are usually prescribed to those in high risk groups. Secondary prevention is the use of preventative drugs or procedures and/or a lifestyle change after a patient has had a CHD or expressed symptoms. Although strictly this could be classed as treatment as it is directly treating symptoms, usually it is before the patient has developed a major CHD and is often prescribed as a result of rise in blood pressure or similar symptoms. ...read more.

Conclusion

one of the major problems in reducing the prevalence of CHD is people's continued complacency about major risk factors such as smoking, physical inactivity and obesity. Despite increasing knowledge about the dangers of certain risk factors, the message that CHD is largely preventable is clearly not getting through: * Smoking levels remain static in the UK - 29% of men and 25% of women still smoke. * Around 40% of men and women have raised blood pressure - despite recent evidence from the World Health Organisation (WHO) that it is the second most important cause of death and disability in developed countries - exceeded only by tobacco. * Only 13% of men and 15% of women eat the recommended 5 portions of fruit and veg a day. While the consumption of fruit has risen four fold since the 1940s, vegetable consumption has declined. * Physical inactivity is still a major problem - only just over a third (37%) of men and a quarter of women (25%) take the recommended 30 minutes of exercise five times a week. * The proportion of adults who are overweight continues to rise - particularly in men. Obesity rates in men have tripled in the since the mid 1980s - with men now as likely to be obese as women. * In the last ten years, the number of women drinking more than the weekly recommended levels of alcohol has risen by over 50% but remained stable in men. We need to put increasing pressure on people in the UK to take responsibility for their own health. The major risk factors, such as smoking and obesity, are now well documented - and yet the number of people ignoring these warnings continues to rise. We need to accept that as a nation we are putting our hearts at risk - and identify ways to put people 'on alert' - to reduce the needless suffering from heart disease in the UK today. Rosie Waldron 12 WMS 1 ...read more.

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