Background Epidemiology studies of cardiovascular disease in young athletic populations usually concentrate on mortality due to methodological convenience, but cardiovascular disability is also likely to be prevalent.Medical discharges from the UK Armed Forces may provide an insight to the underlying burden of cardiovascular disease. Methods All discharges on medical grounds were reported to Defence Statistics and categorised using the WHO ICD-10 system.Discharges due to cardiovascular disease between April 1995 to March 2012 were compiled with crude rates recorded per 100,000 Service years. Results 651 cardiovascular discharges were recorded over 2,935,430 Service years (rate 22.18 per 100,000). Males comprised 91.3% of the population but only 88.8% of discharges. Cardiac causes accounted for 37.2% of cases (242 discharges, rate 13.93 per 100,000), with ischaemic heart disease the most frequent diagnosis (92 discharges, rate 3.13 per 100,000). Other important cardiac diagnoses were cardiomyopathy, arrhythmia, conduction and congenital abnormalities, valve dysfunction and infectious diseases. Extra-cardiac disease accounted for 63% of diagnoses (409 discharges, rate 13.93 per 100,000) with Reynaud’s syndrome (85 discharges, rate 2.90 per 100,000) stroke (83 discharges, rate 2.83 per 100,000) and venous diseases, including thromboembolism (61 discharges, rate 2.08 per 100,000) the most frequent. Discussion Cardiovascular disease causes a significant and unrecognised morbidity burden on the UK military. Much is due to stroke and ischaemic heart disease and policies directed at reducing disease development may be preventative. Effective screening for inherited or congenital disorders at the point of recruit entry would allow early identification and intervention in these disorders.
Background It is known that approximately 10% of deaths in the UK Armed Forces result from cardiovascular disease.Characterisation of the underlying diagnoses has never been performed and doing so may present opportunities for preventative intervention. Methods All military deaths are reported to Defence Statistics.They are cross referenced with death certificate and autopsy information and categorised using the WHO ICD-10 system.Deaths were recorded from April 1995 to March 2011 inclusive with crude rates recorded per 100,000 Service years. Results 253 cardiovascular deaths were recorded over 2,765,410 Service years (rate 9.15 per 100,000).Males comprised 91.3% of the population at risk but 96.0% of deaths.In those aged <35 years 90 deaths (rate 3.25 per 100,000) were recorded with 163 deaths in those >35 years (rate 5.89 per 100,000).The most common cause of death was secondary to atheromatous coronary artery disease (107 deaths, rate 3.87 per 100,000). More than a quarter were due to congenital and inherited diseases (33 deaths, rate 1.19 per 100,000) or Sudden Arrhythmic Death Syndrome (SADS) (36 deaths, rate 1.30 per 100,000); a syndrome often due to various inherited conditions. Other important causes were strokes, aortic dissection, myocarditis, vascular disease and pulmonary emboli. Discussion Cardiovascular disease from ischaemic heart disease and inherited conditions cause a significant mortality burden.Policy should be directed at minimising the development of ischaemic heart disease.As inherited cardiac disease deaths usually occur in individuals asymptomatic prior to death early disease identification through screening might prevent many of these deaths.
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