Prevention of cardiovascular disease in general practice: a proposed model.

Abstract

A screening model based in general practice for the detection of subjects at risk of premature cardiovascular disease is described. Opportunistic screening is performed by a trained nurse who also gives initial advice on management. Immediate feedback to patients is possible since a rapid dry chemistry technique is used to measure blood cholesterol concentrations. The collation and analysis of data are achieved using a microcomputer. A central deidentified database is incorporated to allow epidemiological studies and intervention strategy evaluations to be made. Nineteen health centres have evaluated the model, and 40,000 subjects have been screened: 10% had diastolic blood pressures of over 95 mm Hg and 15% had a blood cholesterol concentration over 7 mmol/l (270 mg/100 ml) and 2% over 9 mmol/l (347 mg/100 ml). The initial data suggest that the model is acceptable to both health centre personnel and the general public and that the offer of screening is taken up by all elements of the target population.

Screening for increased cardiometabolic risk in primary care: a systematic review

“…Twenty-one screening programmes were performed in mixed populations ( Table 2). [4][5][6][7][14][15][16][17][18][19][20][21][22][23][24][25][26][27] The British Family Heart Study reported which part of their study population was not previously diagnosed with coronary heart disease, high blood pressure, high cholesterol, or diabetes. None of the other studies provided any information about the composition of their study population.…”

“…Two studies asked people to participate in screening during a regular GP visit; 22 in one of them people could also attend on their own request. 16 Cope et al informed people about the screening through public advertising inside and outside the general practice. 4 Two studies combined the active and opportunistic approaches.…”

“…Prevalence of hypercholesterolaemia (total cholesterol ≥6.5 mmol/l) ranged between 24% and 48% for females, and 26% and 46% for males. 14,17,21,22,[25][26][27] Seven studies calculated a cardiovascular risk score for participants: 15,16,[19][20][21]24,28 five studies reported results. 15,19,20,24,28 Apparently healthy people versus a mixed population.…”

Effectiveness of a dietary intervention strategy in general practice: effects on blood lipids, health and well-being

“…This was followed by four visits at the doctor (15 min each) alternated with four visits at the dietitian (20 min each) during the 1-year treatment. The alternating visits allowed patients to discuss healthrelated problems and problems related to the dietary change.…”

Sex Difference in Risk Factors of Lipid Metabolism for Coronary Artery Disease.

“…Coronary artery disease (CAD) is among the most common causes of death in industrialized and developing countries [1,2]. The lipid parameters such as total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), TC/HDL-C ratio, and triglyceride (TG) are being discussed among the risk factors of CAD [3]. Studies relating to the etiopathogenesis, diagnosis, treatment, and prognosis of coronary artery disease are constantly accumulating.…”