The researchers examined different screening strategies to determine which ones were most effective. These included inviting all 40-74 year olds for vascular screening (Department of Health recommendation), inviting 50-74 year olds for screening, inviting overweight men and women for screening, asking patients to complete a heart disease risk questionnaire (those with a high score would be invited for screening), and finally inviting patients whose data from their electronic patient records would flag them up as high risk.

The results show that the final strategy - using routine data to select high risk patients - is just as effective at the government screening programme at preventing new cases of heart disease and will save costs. A similar benefit could be achieved by inviting all 50 to 74 year olds for vascular screening (rather than starting at the age of 40).

In conclusion, the authors say that: "a universal screening programme for cardiovascular disease might prevent an important number of new cardiovascular events in a population, but it may be unrealistic to implement in increasingly resource constrained health systems- policy makers have to decide on the balance between the number of people needed to screen or treat and the number of cases that can be prevented in the population."

In an accompanying editorial, Tom Marshall from the University of Birmingham, agrees that targeted screening programmes should be used. He says: "there are untreated patients at high risk of cardiovascular disease, most of whom can be identified from their electronic primary care records - we should act on this information."

Source: BMJ-British Medical Journal