Cardiovascular Health

Figure 1 : Risk factors for Heart & Circulatory Diseases

Hypertension

High systolic blood pressure (hypertension) is a leading modifiable risk factor related to cardiovascular mortality. High blood pressure can be controlled by taking steps towards a healthier lifestyle, this includes:

• Maintaining a healthy body weight,
• Taking up physical activity on a regular basis,
• Eating a balanced diet (reducing your sodium intake),
• Following good sleep hygiene,
• Reducing stress
• Know your numbers, ideal blood pressure is considered to be between 90/60mmHg and 120/80mmHg. If you have any concerns, you can check your blood pressure at a local pharmacy or the Primary Care Centre.

Figure 2: Gibraltar Health Authority – Hypertension Statistics

Analysis of 21,448 Gibraltar Health Authority patient records found that 3564 patients had a recorded diagnosis of hypertension (existing or new). Of this sample, 50.1% (n=1786) were male, 49.9%(n=1778) female. The youngest male and female recorded with hypertension were 27 years and 28 years old respectively. The mean age of patients recorded with a diagnosis of hypertension was 65.4 years for males and 68.0 years for females. The number of people diagnosed with hypertension has steadily increased between 2015 and 2019. In 2022 the data suggests a significant increase in number of people diagnosed with hypertension. However, in 2022, GPs carried out an audit in order to improve coding and code patients who were taking hypertensive medications correctly. This means the rise seen does not reflect an increase of hypertension within the community, but rather an improvement in coding.

Figure 3: Diagnosis of cardiac arrest, Accident and Emergency, St. Bernard’s Hospital 2015-2021.

Data in figure 3 shows that the number of cardiac arrests diagnosed increased between the years 2015 and 2018. Higher numbers of cardiac arrest in 2017 and 2018 are likely due to high numbers of patients conveyed by ambulance to the hospital. Changes after this period mean that ROLE (recognition of life extinct) procedures were carried out more frequently in the community by paramedics.

Figure 4 : Diagnosis of hypertension assigned at A&E, St. Bernard’s Hospital.

The number of patients receiving a diagnosis of hypertension at A&E has remained relatively low, with numbers peaking in 2020. Hypertension is generally not diagnosed in the emergency department as multiple blood pressure measurements over a period of time are usually required for a diagnosis. Additionally, the A&E setting may result in the ‘white coat effect’ among patients, whereby blood pressure is raised as a result of the stress induced by the hospital setting. Commonly patients present to A&E due to a high home blood pressure reading and may already be known to have high blood pressure.

Useful resources

Recommendations & Future direction of travel :

Future analysis of statistics will look at prevalence of various cardiac incidents diagnosed and treated at St. Bernard’s. Determining how many patients are residents, compared to numbers of visitors will be an important aspect of future JSNA phases.

Understanding cardiovascular disease prevalence among the local population is vital from a primary prevention perspective.  However, General activity data is important in determining impacts on the healthcare system and need for resourcing.

Page last reviewed : December 2023