Acute myocardial infarction and Angina pectoris

In the absence of detailed information on the number of people in the community with angina or who have experienced a heart attack, hospital admissions data for these conditions can be used as a proxy.

Acute myocardial infarction (heart attack) admission data show significant variation between the most deprived and least deprived areas in Wirral. The rate of admission for heart attacks is highest in Bebington & West Wirral PCT, while Birkenhead PCG, which has the highest mortality from heart disease, has the lowest admission rate for heart attacks. This inverse relationship may be due to coexisting disease; delays in calling for help; patients' perception of their symptoms; patient and carer response to symptoms; and overall survival from previous heart attacks.

Angina admissions follow a similar pattern with the more deprived areas generating proportionately fewer admissions.

Possible reasons why individuals, particularly those living in deprived areas, do not seek help or utilise services include:

• the assumption that heart disease is an inevitable consequence of age;
• insufficient knowledge and awareness of risk factors and treatment options;
• ignorance of the signs and symptoms of heart disease, in particular, of heart attacks; and
• poor access to transport.