Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

BACKGROUND: Screening cardiovascular disease (CVD) risk is an important part of CVD prevention. The success of screening is dependent on the rigour with which treatments are subsequently prescribed. AIM To establish the extent to which treatment conforms to guidelines. DESIGN AND SETTING: Cross-sectional study of anonymised patient records from 19 general practices in the UK. METHOD: Data relating to patient characteristics, including CVD risk factors, risk score and prescribed medication were extracted. CVD risk (thus eligibility for cholesterol and blood pressure-lowering treatment) was calculated using the Framingham equation. Guideline adherence was defined with descriptive statistics and comparisons by age, sex and disease were made using χ(2) tests. RESULTS: Of the 34 975 patients (aged 40-74 years) included in this study, 2550 (7%) patients had existing CVD and 12 349 (35%) had a calculable CVD risk or were on treatment. CVD risk was formally assessed in 8390 (24%) patients. Approximately 7929 (64%) patients eligible for primary prevention therapy were being treated appropriately for their CVD risk. Guideline adherence was higher in younger patients (6284 [69%] aged 40-64 years versus 1645 [50%] aged 65-74 years, P<0.001) and in females (4334 [69%] females versus 3595 [59%] males, P<0.001). There was no difference in guideline adherence between patients where CVD risk had been recorded and those where CVD was calculable. Guideline adherence in patients with existing CVD was highest in patients with ischaemic heart disease (866 [ischaemic heart disease], 52%, versus 288 [stroke], 46%, versus 276 [other CVD], 39%; P<0.001). CONCLUSION: There is scope for improvement in assessment and treatment for prevention of CVD in clinical practice. Increasing the uptake of evidence-based treatments would improve the cost-effectiveness of CVD risk screening programmes.

Original publication




Journal article


Br J Gen Pract

Publication Date





e38 - e46


antihypertensive agents, primary health care, primary prevention, risk, secondary prevention, statins, Adult, Aged, Antihypertensive Agents, Cardiovascular Diseases, Cross-Sectional Studies, Early Diagnosis, Female, General Practice, Guideline Adherence, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Male, Middle Aged, Practice Guidelines as Topic, Primary Prevention, Retrospective Studies, Risk Assessment, United Kingdom, Young Adult