Your report on the falling number of coronary heart disease deaths heralds a positive step towards improving Scotland's reputation for ill health Heart deaths figures for deprived areas fall by 27% but total still lags behind wealthier areas, April 30. Experts have said that the reduction in fatal heart disease is down to people making positive lifestyle choices, such as giving up smoking or taking regular exercise. However, the contribution of thousands of GPs, working at the heart of every local community to tackle one of Scotland's biggest killers, has not been recognised.

Your report on the falling number of coronary heart disease deaths heralds a positive step towards improving Scotland's reputation for ill health Heart deaths figures for deprived areas fall by 27% but total still lags behind wealthier areas, April 30. Experts have said that the reduction in fatal heart disease is down to people making positive lifestyle choices, such as giving up smoking or taking regular exercise. However, the contribution of thousands of GPs, working at the heart of every local community to tackle one of Scotland's biggest killers, has not been recognised.

The quality framework of the new contract focuses on disease management and prevention, and plays a considerable part in reducing the number of significant or life-threatening events for patients suffering from coronary heart disease. BMA Scotland has estimated that by lowering blood pressure and cholesterol levels, and controlling hypertension, more than 1000 cardiovascular events can be prevented within a five-year period. I am, therefore, disappointed that the contribution of general practice in achieving this health improvement has not been recognised by this government.

It is clear, however, that there is still some way to go to improve outcomes for patients in poorer communities. In these areas there are not enough GPs and for those who do work there, they do not have enough time to spend with each patient. A targeted approach must begin in general practice by actively training and recruiting more GPs to work in these hard-to-reach communities.

Dr Dean Marshall, Chairman, BMA Scottish General Practitioners Committee, 14 Queen Street, Edinburgh.