Strategies for reducing risk factors for coronary heart disease in primary care

StrategyInitial screeningAt risk groupAdditional screening for those at risk
1Measure blood pressure, ask about personal historySystolic blood pressure >140 mm Hg, history of ischaemic heart disease, stroke or transient ischaemic attackSmoking, height, weight, diet, family history, cholesterol
2As strategy 1 plus ask about smokingAs strategy 1 plus smokersHeight, weight, diet, family history, cholesterol
3As strategy 2 plus measure of height and weightAs strategy 2 plus body mass index >28Diet, family history, cholesterol
4As strategy 3 plus dietary assessmentAs strategy 3 plus fat intake >110 g/dayFamily history, cholesterol
5As strategy 4 plus family historyAs strategy 4 plus first degree relative with ischaemicheart disease, stroke, or transient ischaemic attack before 60 yearsCholesterol
6As strategy 5 plus measure of blood cholesterolAs strategy 5 plus total cholesterol >7.5 mmol/lNone
  • Diet assessed by simple screening questionnaire. High fat intake defined as>110 g/day, which is equivalent 45% of energy intake in daily diet of 9.2 MJ. .