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The CHD national service framework may have widened age inequalities in the treatment of cardiovascular disease, new research shows.

The study of 55,000 patients found the NSF had substantially improved quality of care within a year of its introduction in March 2000.

But elderly people were 77 per cent less likely to have their cholesterol recorded than younger patients and substantially less likely to have good blood pressure control. The researchers said health interventions could initially widen inequalities, as patients who least needed treatment took it up first.

Study leader Professor Julia Hippisley-Cox, professor of clinical epidemiology and general practice at the University of Nottingham, said GPs had focused on younger patients because the NSF advised identifying those with CHD aged from 35 to 74.

She added: 'We are doing another 10-year study from 1995 to 2005 and under very initial analysis it looks like age inequalities are getting worse.'

The study, published in the British Journal of General Practice (May), examined records from 17 general practices in 2000/1. The proportion of patients with CHD or stroke who had their cholesterol recorded leapt from 28.3 to 47.8 per cent in the year

after the NSF's introduction.

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