Factors associated with successful risk reduction after a community coronary risk factor screen

Debate continues over the effectiveness of coronary risk factor screening as a strategy for the prevention of coronary heart disease in the community. We reviewed changes in risk factors one year after a community coronary risk factor screen and found highly significant reductions in the blood cholesterol (mean reduction of 0.6 mmol/l) and body mass index (mean reduction of 1.03 kg/m2) in those participants who at the initial screening were found to have elevated (greater than 6.5 mmol/l) blood cholesterol concentrations. Comparison of this group with a reference group not given health advice and a group of hypercholesterolaemic clinic attenders showed that the blood cholesterol reduction could not be accounted for solely by regression to the mean, and was as good as the blood cholesterol reduction achieved by regular clinic attendance. Although there were many factors that could account for these reductions, we found that participants who received risk factor measurement and counselling during the screening process and who sought medical follow-up after the screen had a greater reduction in risk factors.