Strategies for reducing coronary risk factors in primary care

BMJ 1995;311:263 (22 July)

Letters

Strategies for reducing coronary risk factors in primary care

EDITOR,--K Field and colleagues claim to have evaluated thecost effectiveness of intervention protocols in primary careto reduce cardiovascular disease.¹ They examined the costs oftreatment with cholesterol lowering drugs (pounds sterling235/year)and ignored the cost of antihypertensive treatment (pounds sterling180-260/year).The costs of medical treatment for both conditions, includingdietary modification of obesity and salt intake in hypertension,were roughly equivalent. Rates of therapeutically importantsevere hypertension (4.4%; 115/2607) and hyperlipidaemia (4.1%;107/2607) are similar,² and some patients need treatment forboth conditions. Calculations of the cost of cardiovascularscreening should be based on the costs of treating both conditionswith advice about lifestyle, diet, and drugs.

The authors' clinical approach used 100 minutes of nursing timeand 10 minutes of the general practitioner's time per patient.It is odd that dietary information was gathered in preferenceto a family history of cardiovascular disease, which is morerelevant . . . [Full text of this article]

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Relevant Article

Strategies for reducing coronary risk factors in primary care: which is most cost effective?: K Field, M Thorogood, C Silagy, C Normand, C O'Neill, and J Muir
BMJ 1995 310: 1109-1112. [Abstract] [Full Text]