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At the heart of general practice since 1960

Heart screening needed despite QOF advances

By Nigel Praities

Large numbers of patients at high cardiovascular risk remain under-diagnosed despite major advances under the QOF, a new study concludes.

The researchers said their work underlined the need for cardiovascular screening, but GPs warned it also indicated the size of the additional workload screening would bring.

GPs diagnosed three times as many patients with high cholesterol in 2006 as in 1998, a study of prevalence on the THIN database revealed. High cholesterol was now diagnosed in a quarter of patients.

But for all this improvement, many more patients remain with undiagnosed cardiovascular risk factors, the researchers said. Prevalence figures from the 2003 Health Survey for England found roughly three-quarters had high cholesterol. The prevalence of hypertension in primary care was also underestimated in general practice, with a rate of 27% compared with a third of the general population.

Professor Thomas MacDonald, head of the medicines monitoring Unit at Ninewells Hospital and Medical School in Dundee, said one explanation for the discrepancies was the lack of screening. ‘It suggests the need to improve screening for hypertension and particularly hypercholesterolaemia in clinical practice,' he said.

But Dr Terry McCormack, chair of the Primary Care Cardiovascular Society, said the study demonstrated the scale of the challenge posed to GPs by cardiovascular screening. ‘We are vastly underestimating the numbers of patients with high cholesterol levels, but this is not a poor reflection on GPs. Going out and finding these patients is something that we will be required to do,' he said.

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