Cardiovascular disease (CVD) remains the leading cause of death in the UK. Reducing the burden of CVD requires both primary and secondary prevention strategies. While there have been some primary prevention strategies in the UK over the past decade, there has been far greater focus on secondary prevention strategies targeting high risk individuals. The National Health Service (NHS) Health Check, a national primary prevention programme for vascular disease, aims to improve the prevention and early diagnosis of CVD.
In an article published recently in the medical journal JRSM Short Reports, Macide Artac and Colleagues from the Department of Primary Care & Public Health at Imperial College London assessed measurement and level of CVD risk factors (blood pressure, cholesterol, body mass index (BMI), blood glucose and smoking status) before implementation of NHS Health Checks in general practices in the London Borough of Hammersmith & Fulham.
They found a high rate of recording of smoking status (86%) and blood pressure (83%); whilst BMI, cholesterol and glucose recording was lower. There was a large variation in BMI, cholesterol, glucose recording between general practices (e.g. 30–92% for BMI). Women had significantly better risk factor recording than men and all risk factors were better recorded in the least deprived patient group . Age-adjusted levels of cholesterol and BMI were not significantly different between men and women. Men were more likely than women to have raised blood glucose, blood pressure and BMI.
Macide Artac and colleagues concluded that before the start of the NHS Health Check programme, CVD risk factor recording varied considerably by practice and patient characteristics. They also identified significantly elevated levels of CVD risk factors in the population eligible for a Health Check, which will require considerable work to manage well.
The figure shows the general practice level variation in recording of cardiovascular disease risk factors within last 5 years.