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

doi:10.1136/bmj.a1371

From trainee to consultant, BMJ Group offers doctors around the world tailored information, special events, learning resources and recruitment services at every step along their career path.

... by doctors, for doctors, for patients
We are open for entries!

Online learning

BMJ Learning

High-quality CME / CPD for doctors and other healthcare professionals. BMJ Learning features hundreds of accredited, peer-reviewed learning modules in text, video, and audio formats. Find out more

Courses and Qualifications

BMJ Masterclasses

BMJ Masterclasses, led by experts, help clinicians to use the latest evidence and recent guidelines in practice and meet their CPD/CME requirements. Find out more

Exam Preparation

The leading provider of online exam preparation, helping over 167,000 healthcare professionals to pass their exams. Find out more

onExamination

Search all BMJ comment articles:

From

Limit by

Our online table of contents is updated at least twice each day. Read all articles published in the last 7 days.
Keep up to date with cardiology: Access the latest cardiovascular medicine resources from across BMJ Group.
The BMJ iPad app brings you the best of print and online, including live links to the latest news, blogs, video, and podcasts. Get the BMJ iPad app.
OPEN ACCESS: All research articles are freely available online, with no word limit. Find out more about the BMJ's open access policy. Submit your paper.
Countdown to London 2012: BMJ Group's Olympics portal highlights latest Olympics and sports medicine-themed research, comment and learning

Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

Rod Jackson, professor of epidemiology,
Sue Wells, senior lecturer in clinical epidemiology,
Anthony Rodgers, professor of epidemiology

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

Correspondence to: R Jackson rt.jackson{at}auckland.ac.nz

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

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 …