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Coronary risk factor screening and long-term follow up: year 1 of the Sydney Coronary Heart Disease Prevention
Insights
A large screening of Sydney residents identified significant rates of undiagnosed hyperlipidemia, hypertension, and diabetes, particularly in younger adults. Follow-up showed treatment reduced key coronary risk factors.
Area of Science:
- Cardiology
- Public Health
- Preventive Medicine
Background:
- Coronary heart disease remains a leading cause of mortality globally.
- Early identification and management of risk factors are crucial for prevention.
- Population-based screening can reveal the prevalence of modifiable risk factors.
Purpose of the Study:
- To screen a large, self-referred urban population for major coronary risk factors.
- To assess the prevalence of undiagnosed conditions like hyperlipidemia, hypertension, and diabetes.
- To evaluate the impact of general practitioner referral and subsequent treatment on risk factor control.
Main Methods:
- A one-year screening of 10,000 self-referred Sydney inhabitants for coronary risk factors.
- Referral of identified issues to general practitioners for assessment and treatment.
- Retesting of a random subset (n=354) at 8 and 15 months to assess treatment efficacy.
Main Results:
- High prevalence of unsuspected hyperlipidemia (29%), hypertension (11%), and diabetes (0.6%) in those under 65.
- Among those with a history of hypertension, 46% had well-controlled blood pressure (<95 mmHg diastolic).
- Cigarette smoking decreased with age; 10.4% of males and 4.9% of females under 40 had multiple risk factors.
- Retesting showed significant reductions in body weight, blood pressure, and plasma cholesterol.
Conclusions:
- Population screening effectively identifies individuals with significant coronary risk factors, including undiagnosed conditions.
- General practitioner referral and treatment lead to measurable improvements in key cardiovascular risk markers.
- Targeted interventions and ongoing management are essential for reducing the burden of coronary heart disease.
Abstract:
Ten thousand self-referred Sydney inhabitants were screened for major coronary risk factors over one year. Individual "problems" were referred to general practitioners for further assessment and treatment. Seventy-four per cent of subjects have attended a general practitioner where relevant. For subjects under 65 years, 29% had unsuspected hyperlipidaemia, 11% had unsuspected hypertension, and 0.6% had unsuspected diabetes. Nineteen per cent of subjects reported a past history of hypertension, of whom 46% appeared to be well-controlled (diastolic blood pressure less than 95 mmHg). The numbers of cigarette smokers fell with increasing age. Considering hyperlipidaemia, hypertension and cigarette smoking in subjects under 40 years of age, 10.4% of males and 4.9% of females had two or more coronary risk factors. Three hundred and fifty-four subjects selected at random, who claimed to be receiving treatment as a result of initial screening were invited for retesting eight and 15 months later. Significant falls were noted in body weight, blood pressure, and plasma cholesterol readings.