Published 28 August 2008, doi:10.1136/bmj.a1371
Cite this as: BMJ 2008;337:a1371

Head to Head

Will screening individuals at high risk of cardiovascular events deliver large benefits? Yes

¹ School of Population Health, University of Auckland, New Zealand

The Department of Health is planning to identify and treat all adults over 40 at high risk of a cardiovascular event. Rod Jackson and colleagues argue that a well targeted programme will save many lives, but Simon Capewell (doi: 10.1136/bmj.a1395) thinks whole population approaches would be more cost effective

The first 150 words of the full text of this article appear below.

Provisional modelling by the Department of Health suggests that up to 9500 heart attacks and strokes and 2000 deaths could be prevented each year by its plan to screen for and manage vascular risk in people aged between 40 and 74.¹ Checks would comprise a brief history, examination, and blood test and could take place in general practices or pharmacies. The programme will be implemented in 2009-10 at an annual cost of about £250m (315m; $465m).¹ This strategy assumes that the high risk approach to preventing cardiovascular disease is effective and cost effective, which we believe to be true.

A large World Health Organization review comparing high risk and population-wide interventions to prevent cardiovascular disease globally showed that treating high risk patients with aspirin, off-patent statins, and blood pressure lowering drugs was not only cost effective but would avert more disability adjusted life years (DALYs) worldwide than population based . . . [Full text of this article]

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This article has been cited by other articles:

• de Koning, H. J. (2009). Testing at home--the screening of the future?. Eur J Public Health 0: ckn120v1-ckn120 [Full text]  
• Hackett, G. I (2008). Erectile dysfunction predicts cardiovascular risk in men. BMJ 337: a2166-a2166 [Full text]  

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