The Pharmaceutical Journal Vol 267 No 7178 p839-846
15 December 2001

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Drinking, hypertension and epilepsy are major health challenges, says CMO

The annual report of the Chief Medical Officer for England, published this week, highlights a number of health issues that pharmacists' involvement could help to improve. This year the major challenges include liver cirrhosis, hypertension, epilepsy and health inequalities.

Liver cirrhosis Large rises in death rates from chronic liver disease and cirrhosis have occurred in most age groups. An increase in the number of women drinking above the recommended weekly consumption levels is noted. For both young men and women there is evidence that a substantial number is drinking heavily and also binge drinking. The report suggests that people who are problem drinkers should be identified early and helped to modify their drinking patterns. The rising trend in deaths from cirrhosis seen in England contrasts with most other European countries which are showing declining trends.

Hypertension At least five million people are not taking medication for high blood pressure or are being treated ineffectively, the report says. It recommends that action is needed to increase "public and professional awareness of the problems of hypertension". In particular, it highlights the importance of changing lifestyle factors — reducing salt intake, increasing fruit and vegetable consumption, reducing obesity and increasing physical activity.

Epilepsy An estimated one in 130 people in England have epilepsy. The report says: "People with epilepsy are at triple jeopardy: they suffer social stigma because of their disease, understanding of the illness among health professionals is not high and the problem is not addressed by health services with the same commitment as is given to other chronic diseases like diabetes mellitus." In particular, it notes that up to 20 per cent of patients might be misdiagnosed and might receive inappropriate or unnecessary treatment. The report recommends that greater public and professional awareness about epilepsy is needed and that professional bodies should ensure that sufficient expertise in epilepsy is contained in training programmes.

Health inequalities Despite overall improvements in health, the gap between socially disadvantaged and affluent sections of the population has widened. Some of these differences can be explained by behaviour and lifestyle factors, but a large part of the difference is a result of underlying social, economic and environmental factors, the report concludes.

The report can be found on the Department of Health's website (www.doh.gov.uk/cmo/annualreport2001).

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