Cardiovascular screening to reduce the burden from cardiovascular disease: microsimulation study to quantify policy...

Area of Science:

• Public Health
• Epidemiology
• Health Economics

Background:

• Cardiovascular disease (CVD) remains a leading cause of mortality and morbidity.
• Socioeconomic inequalities in health exacerbate the CVD burden.
• The National Health Service Health Checks program offers universal screening for primary CVD prevention.

Purpose of the Study:

• To estimate the impact of universal screening (NHS Health Checks) on CVD burden and socioeconomic inequalities in England.
• To compare universal screening with alternative primary prevention strategies.

Main Methods:

• Microsimulation study using a synthetic population representative of England.
• Evaluation of five scenarios: baseline, universal screening, concentrated screening, population-wide intervention, and a combined approach.
• Analysis of CVD cases and deaths prevented or postponed by 2030, stratified by socioeconomic status.

Main Results:

• Universal screening may prevent 19,000 CVD cases and 3,000 deaths by 2030.
• Population-wide interventions and combined strategies show significantly greater impact, preventing up to 82,000 cases and 9,000 deaths.
• Combined population-wide intervention and concentrated screening emerged as the most equitable strategy, reducing socioeconomic inequalities in health.

Conclusions:

• Universal screening for CVD prevention is less effective than strategies incorporating population-wide interventions.
• Further research is needed to optimize the mix of population-wide and targeted strategies for cost-effectiveness and inequality reduction.