Cardiovascular Disease in Scotland: A Striking Inequality

In a bustling Glasgow clinic, Dr. Fiona McGregor examines a 62-year-old patient, his face lined with worry. As she checks his blood pressure, she knows the statistics by heart: people in this city are dying from cardiovascular disease at an alarming rate. The numbers tell a grim story: Glasgow City boasts the highest rate of premature mortality from cardiovascular disease in the UK, a haunting reminder of a health crisis that persists amid advances in treatment and research.

The State of Cardiovascular Disease in Scotland

With over 7.6 million people across the UK living with cardiovascular disease (CVD), the impact is staggering—twice as many as those battling Alzheimer’s and cancer combined. However, the narrative is not solely one of despair. Since 1961, the average annual deaths from heart and circulatory diseases have nearly halved, and the age-standardised death rate has dropped by three-quarters. Yet, these headlines obscure a disturbing reality of inequality, particularly evident in Scotland.

“What we’re witnessing is not just a healthcare issue but a profound social problem,” notes Dr. Ian Henderson, a public health researcher at the University of Edinburgh. “The disparities are stark and require immediate attention.”

Navigating the Disparities

The impending collaboration between the Institute for Public Policy Research (IPPR) and the British Heart Foundation seeks to investigate these disparities across the UK. Scotland stands out, having compiled some of the most comprehensive data on CVD risk factors and outcomes. The Primary Care Intelligence Service, which encompasses nearly all GP practices in Scotland, provides a definitive snapshot of the health landscape.

Data from April 2025 highlights alarming trends: neighborhoods plagued by deprivation exhibit substantially higher rates of CVD and its risk factors. For instance, in deprived areas, diabetes prevalence is disproportionately elevated. Adults with diabetes face a two to fourfold increased risk of developing cardiovascular complications, while hypertension remains the top risk factor for various heart diseases.

• 1 in 4 deaths in Scotland is attributed to CVD.
• Cardiovascular conditions are expected to increase by 16% in the next decade.
• Patients in the most deprived areas exhibit a 1.8 times higher prevalence of diabetes compared to their less deprived counterparts.

Evidence of Socioeconomic Impact

Our analysis reveals a clear socioeconomic gradient across Scotland. For coronary heart disease and heart failure, GP practices in deprived regions show significantly higher patient numbers:

“The data paints a clear picture,” says Dr. Sarah Mitchell, a cardiology expert at the University of Glasgow. “Those from less privileged backgrounds carry an unfair burden of cardiovascular disease, and it’s evident that we need targeted interventions.”

For example, GPs in the most deprived decile report 1.4 times more male patients with coronary heart disease and 1.8 times more female patients than those in the least deprived areas. This inequity breeds a cycle of chronic health issues.

Geographic Variations and Their Implications

The research extends its reach across Scotland’s 31 Health and Social Care Partnerships, revealing considerable variation. Urban areas, such as East Ayrshire, showcase alarmingly high rates of CVD, in contrast to regions like Perth and Kinross, where numbers are significantly lower. This geographic disparity underscores the need for tailored, local approaches to cardiovascular health.

Strategies for Improvement

As the landscape for heart health evolves, Scotland’s NHS has recognized the urgency of tackling CVD. The Operational Improvement Plan positions cardiovascular disease prevention at the forefront of healthcare priorities, emphasizing the identification and management of unmet needs.

“The focus moving forward must be on sustainable prevention and equitable access to treatment,” states Dr. Evans, a consultant cardiologist. “We must ensure resources flow to where they are most needed—our most deprived areas.”

A Crucial Turning Point

Critically, Scotland finds itself at a crossroads with its Heart Disease Action Plan (HDAP), launched in 2021. The plan has begun to drive improvements in cardiology services, yet concerns loom as its expiration date approaches in 2026. Without clear commitments to its renewal, the risk of losing hard-fought advancements grows ever more likely.

Failure to prioritize CVD could see disproportionate impacts on deprived communities deepen. Dr. McGregor emphasizes, “If the focus shifts away from cardiovascular issues, we may very well see the inequalities perpetuated. We cannot afford to let history repeat itself.”

As Scotland grapples with this persistent health crisis, the challenge lies in bending the curve of inequality. Safeguarding hard-won progress requires dedicated policies focused on prevention, timely access to services, and strategic investment in the very communities most affected.

While research continues to highlight these disparities, they also illuminate a path forward. Scotland stands at a decisive moment, with the potential to lead the way in addressing cardiovascular inequalities, ensuring that all Scots can access the care they need for a healthier future.

Source: www.ippr.org