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Doubt cast on GP arterial screening

General practice screening for peripheral arterial disease may not be as useful as previously thought.

Studies had suggested yields of up to 29 per cent were possible with GP screening of the over 60s, but a new trial found a prevalence of only 8 per cent when existing hypertension and diabetes were excluded.

By specifically excluding those already targeted for secondary prevention, screening had much less impact than expected, the Scottish Executive-funded study found.

Study leader Dr Neil Campbell, reader in general practice at the University of Aberdeen and an associate GP in Torphins, Aberdeenshire, said: 'It is feasible to screen for peripheral arterial disease in primary care, but its prevalence is lower than anticipated. There is room for improvement in secondary preventive treatment and lifestyle, so a structured programme could still have important benefits for survival.'

Carried out at a practice in north-east Scotland, the study identified patients aged 60 or over with hypertension but no cardiovascular disease or diabetes. They were invited to a screening clinic where information on ankle brachial pressure index, preventive treatment and risk factors was collected.

Some 379 patients attended screening and 30 had peripheral arterial disease – only six of whom had been previously diagnosed.

Dr Ahmet Fuat, a GP principal and CHD lead for Darlington PCT, said: 'Many of these patients do fall into many of the categories we look after anyway. They need to look at the cost-

effectiveness.'

The study was published in the April issue of the British Journal of General Practice.

• Expert advice on heart disease at our seminar – details page 64

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