Action to prevent cardiovascular disease ‘can go further’ with support from pharmacy professionals, the chief medical officer (CMO) for England has stressed.

Speaking at the King’s Fund annual conference this week, Professor Chris Whitty said prevention for cardiovascular disease must be extended out of general practice and into the ‘entire medical, nursing and pharmacy professions’.

Professor Whitty said that ‘secondary prevention’ of cardiovascular disease, where a patient had a risk factor such as a test result or early signs of disease picked up, had ‘transformed’ the potential to treat the condition.

‘People who get early disease, or indeed ID before disease, are not going on to have severe disease limit their life in their early old age,’ he said as part of a talk on the future of healthcare with an ageing population.

And while he said that medications such as beta blockers, ACE inhibitors, antiplatelets and anticoagulants were ‘things that you would expect to be done conventionally by general practice’, he believed that cardiovascular outcomes ‘will only continue to improve if we extend this out beyond general practice’.

‘If the entire medical, nursing and pharmacy professions take this on, we can go further in this area,’ he said, commenting that leaving it solely with general practice would not go far enough or reach key populations.

He also highlighted the need for the accessibility of healthcare, particularly with a higher concentration of heart disease among older people, who increasingly live in more isolated and peripheral areas, as well as among those living in more deprived areas.

‘The growth of elderly is going to be almost entirely geographically peripheral,’ said Professor Whitty.

‘And our health system is not designed for that. It's very centralised.

‘And currently, in my view, we are failing the peripheral areas. This is an entirely solvable problem, provided we take a long run up at it.’

Several panellists throughout the conference also spoke about the importance of cardiovascular prevention in public health.

Professor Maggie Rae, president of the epidemiological and public health section of the Royal Society of Medicine, said that controlling people’s blood pressure was one of the top two changes that could be made to improve public health.

But with no integrated care boards (ICBs) currently reaching targets around this, she warned: ‘We are failing people on that.’

She also highlighted smoking as ‘the biggest cause of health inequalities’, calling the government’s plans to create a smoke free generation a ‘golden ticket’ – although she said that smoking cessation on that scale was an ‘easy thing to say and a hard thing to deliver’.

And Dr Axel Heitmueller, managing director at Imperial College Health Partners, highlighted the need to take action on public health issues such as hypertension, to allocate multi-year budgets to public health, and to make use of services like community pharmacies.

At the same event, Amanda Pritchard, chief executive of the NHS, said that the health service was making progress on its prevention agenda, meeting its target of having 90% of patients with atrial fibrillation on direct oral anticoagulants (DOACs) six years ahead of schedule.

Community pharmacy organisations have long highlighted the need for 'life-saving' interventions based in community pharmacy to prevent excess deaths caused by cardiovascular disease.

And in May 2023, community pharmacies in England delivered a total of 149,865 blood pressure checks to over 40s – over double the 58,345 delivered in the same month last year.

Community Pharmacy England’s recent vision for the sector, developed with The King’s Fund and Nuffield Trust, suggested that hypertension case-finding, atrial fibrillation detection, and smoking cessation could become additional commissioned services which all pharmacies could choose to provide over the next five years.

The report also proposed that community pharmacies could be locally commissioned to manage long-term conditions such as hypertension, lipid control and asthma.

And within 10 years, the hypertension and atrial fibrillation case-finding service could become one of a set of essential services which all community pharmacies would be expected to provide, the report suggested.