Cardiovascular disease (CD) - QOF indicator

The cardiovascular disease (CD) indicators assess blood pressure control in patients with coronary heart disease (CHD), stroke or TIA. For 2026/27, previously separate CHD and stroke blood pressure indicators have been brought together within the CD set, with age-specific targets and exclusions for moderate or severe frailty.

Ongoing management

Why this indicator set is included

• Evidence supports the benefits of correctly diagnosing and treating CHD and stroke: mortality can be reduced and patient outcomes improved. These indicators therefore concentrate on care for people whose CHD or stroke is already established.

CD001

CD001 draws on NICE IND241 and IND243.

Rationale

• For patients aged 79 years or under with CHD or a previous stroke or TIA, CD001 assesses an intermediate outcome: blood pressure of 140/90 mmHg or less. Controlling blood pressure supports secondary prevention of cardiovascular disease, whether achieved with lifestyle advice or medication.

• NICE distinguishes between clinic measurements and Home Blood Pressure Monitoring (HBPM) when setting targets. For stage 1 hypertension, the clinic target of 140/90mmHg equates to 135/85 mmHg with HBPM; CD001 reflects this distinction.

• In 2026/27, CD001 brings together the previously separate CHD and stroke blood pressure monitoring indicators. It also reflects NG136, the NICE hypertension guideline, which advises clinical judgement when choosing blood pressure targets for people with frailty. Leaving patients with moderate to severe frailty outside the indicator allows practices to tailor hypertension care to the individual and take multimorbidity into account.

Reporting and verification

• The criteria practices must meet are set out in the CD001 definition in the table above.

CD002

CD002 draws on NICE IND242 and IND244.

Rationale

• CD002 uses blood pressure of 150/90 mmHg or less as an intermediate outcome for patients aged 80 years or over who have CHD or a previous stroke or TIA. This target follows NICE's hypertension guidance and is intended to support secondary prevention of cardiovascular events by achieving adequate blood pressure control.

• The target depends on where blood pressure is measured, in keeping with NICE guidance. A clinic measurement of 150/90mmHg corresponds to an HBPM measurement of 145/85 mmHg.

• For 2026/27, the previously separate CHD and stroke blood pressure monitoring indicators are combined in CD002. The exclusion of patients with moderate to severe frailty puts into practice the NG136 recommendation to apply clinical judgement to blood pressure targets in frailty. Practices can consequently individualise hypertension management while considering the patient's multimorbidity.

Reporting and verification

• The CD002 definition in the table above specifies the criteria for this indicator.