Comparison of methods to identify individuals at increased risk of coronary heart disease from the general population BMJ Volume 326, pp 1436-8
Measuring the cholesterol of everyone aged 50 years and over is a simple and efficient way of identifying those at high risk of heart disease in the general population, suggest researchers in this week’s BMJ.
Over 6,000 people aged between 30 and 74 years with no history of heart attack, stroke, or angina took part in the study. Four common screening tests were compared to identify those at a 10 year coronary risk of 15% or greater – national guidelines, Sheffield tables, age threshold of 50 years, and risk assessment using fixed cholesterol values.
Although the Sheffield tables identified almost all (99.91%) of people at 15% or greater risk, this strategy required measurement of cholesterol in 73% of the study population. In contrast, the screening test based on age required measurement of cholesterol in only 46% of the population and led to 93% of those at 15% or greater risk being identified.
The simplicity of this method may also help to increase the uptake in screening and help to identify people with other modifiable risk factors (such as high blood pressure, diabetes, and smoking) and thus lead to an integrated screening programme for coronary heart disease, say the authors.
This study contributes to the debate on how limited resources are targeted to those people who are most likely to benefit from treatment to reduce their risk of heart disease, they conclude.