Results and efficacy of public screening for hypercholesterolemia: the Bavarian Cholesterol Screening Project

Hypercholesterolemia is a risk factor for the development of coronary disease. It does not present with symptoms and can be diagnosed by laboratory examination only. Screening is the only means to detect subjects at risk at a time when preventive measures can effectively be applied. We therefore initiated the Bavarian Cholesterol Screening Project (BCSP). Occasional screening was performed in 150,089 subjects (81,286 women, 68,803 men) in 214 campaigns. The mean cholesterol value was 243 +/- 52 mg/dl for women and 231 +/- 53 mg/dl for men; 37.3% of women and 38.1% of men had values of 201-250 mg/dl, 42.2% of women and 33.7% of men values > 250 mg/dl. Also, the following risk factors were recorded: smoking in 11.3% of women and in 20.2% of men, hypertension in 19.8% of women and 17.4% of men, diabetes mellitus in 4.2% of women and 4.1% of men, obesity in 16.8% of women and 20.9% of men, and a family history of myocardial infarction in 34.8% of women and 26.0% of men. Of the 27,084 men who had their cholesterol checked for the first time, 35.6% had levels between 201 and 250 mg/dl, and 22.9% had levels above 250 mg/dl. Of the 27,870 women whose cholesterol level had not been checked before, 38.8% had levels between 201 and 250 mg/dl, and 27.1% had levels above 250 mg/dl. More than 70% of the subjects with levels between 200 and 250 mg/dl had at least one additional risk factor. We conclude, on the basis of this study, that the risk factor hypercholesterolemia is unknown in as much as 20% of the population of Bavaria. These newly detected subjects were offered the opportunity to recognize this risk and take subsequent measures of prevention. Screening projects for hypercholesterolemia therefore can be an effective means of improving public health.