Table 4

Primary care interventions: estimated current uptake, additional number of preventable deaths or events with full uptake in a population of 100 000, and likely cost effectiveness

InterventionEstimated currentAdditional No of preventable deaths or events with full uptakeLikely cost effectiveness
uptake among eligible patients (%)*
Aspirin for patients at high risk of coronary or ischaemic cerebrovascular events5024 deaths over 1 year; 22 vascular deaths over 1 year; 22 non-fatal MIs over 1 year; 59 non-fatal strokes over 1 yearLikely to be cost effective
Control of hypertension40171 deaths over 4 years; 107 CHD deaths over 4 years; 92 cerebrovascular deaths over 4 yearsVery cost effective for first line drugs, but less so for more expensive drugs and for older people
Advice on stopping smoking or nicotine replacement therapy3479 deaths over 1 yearLikely to be cost effective
Angiotensin converting enzyme inhibitors for patients with heart failure2060 deaths over 90 daysLikely to be cost effective, especially if treatment started in primary care. The SOVLD trial showed a reduction in hospital admissions of 30% in those receiving the drug
Statins for patients at high risk of coronary heart disease (secondary prevention)2552 deaths over 5 years; 53 coronary deaths over 5 years; 116 major coronary events over 5 yearsGreatest in patients with highest risk for CHD. Should be used in patients with additional risk factors
Statins for patients at low risk of coronary heart disease (primary prevention)2511 deaths over 5 years; 7 CHD deaths over 5 years; 25 CHD events over 5 yearsShould be used in patients with additional risk factors. Cost effectiveness low in patients with no previous MI or angina
Warfarin for stroke prophylaxis in non-valvular atrial fibrillation3023 deaths each year; 40 stroke events each yearCost effective, especially if at least one additional risk factor for stroke
Influenza vaccination for those aged >6530102 deaths each year; 191 influenza episodes each yearLikely to be cost effective. UK government has recently recommended that all those aged 75 should receive vaccine
  • MI=myocardial infarction; CHD=coronary heart disease.

  • *Details on how we calculated the estimated current uptake rates are in the appendices available on the BMJ website.

  • †References for these statements appear in the appendices available on the BMJ website.