Top professor raises doubts about CV screening rollout
By Nigel Praities
Priority should be given to treating people with established cardiovascular disease before rolling out cardiovascular screening, says an internationally respected epidemiologist.
The comments came in a debate published in the British Medical Journal on the effect of the government's plans for vascular checks for all adults aged 40 to 74 years.
Professor Rod Jackson, head of epidemiology and biostatistics at the University of Auckland, New Zealand, said he supported the idea of vascular screening but said the more important gains were to be had in improving secondary prevention of CVD.
‘Priority should be given to ensuring general practitioners are able to manage patients with prior cardiovascular disease before widening the net too far to lower risk patients,' he said.
Professor Jackson recommended GPs ensured all their patientts with established CVD were taking a triple combination of aspirin, statins and antihypertensives.
Dr John Pittard, a member of the Primary Care Cardiovascular Society and a GP in Staines, Middlesex, agreed with the comments and said the numbers needed to treat would be much greater for primary prevention as opposed to secondary prevention.
‘It is a dilemma that QOF only incentivises secondary prevention in 70% of patients. There has to be a certain degree of flexibility for patient choice and intolerances, but we need to look at closing the gap for the outstanding 30%,' he said.
In a separate editorial in the BMJ, Professor Simon Capewell, professor of clinical epidemiology at the University of Liverpool, argues the vascular screening programme is a ‘costly and relatively ineffective strategy' and recommended the government looked at legislation to encourage healthier lifestyle changes to prevent CVD.