General health screenings to improve cardiovascular risk profiles: a randomized controlled trial in general practice with 5-year follow-up.
OBJECTIVE
To investigate the impact of general health screenings and discussions with general practitioners on the cardiovascular risk profile of a random population of patients.


METHODS
A population-based, randomized, controlled, 5-year follow-up trial conducted in a primary care setting.


METHODS
The study group consisted of 2000 patients, randomly selected middle-aged men and women aged 30 to 50 years from family practices in the district of Ebeltoft, Denmark. Of these patients, 1507 (75.4%) agreed to participate. Patients were randomized into (1) a control group who did not receive health screenings, (2) an intervention group that received 2 health screenings, (3) an intervention group that received both the 2 screenings and a 45-minute follow-up consultation annually with their general practitioner.


METHODS
Cardiovascular risk score (CRS), body mass index (BMI), blood pressure, serum cholesterol, carbon monoxide in expiratory air, and tobacco use.


RESULTS
After 5 years, the CRS, BMI, and serum cholesterol levels were lower in the intervention groups compared with the control group. The improved outcome was greater in the baseline risk groups. The number of patients with elevated CRS in the intervention groups was approximately half the number of patients with elevated CRS in the control group. The difference was not a result of medication use. There was no difference between the group that received consultations after the screenings and the group that had health screenings alone.


CONCLUSIONS
Health screenings reduced the CRS in the intervention groups. After 5 years of follow-up, the number of persons at elevated cardiovascular risk was about half that expected, based on the prevalence/proportion in a population not receiving the health checks (the control group). The impact of intervention was higher among at-risk individuals. Consultations about health did not appear to improve the cardiovascular profile of the study population.
Engberg
Marianne
M
Department of General Practice, University of Aarhus, Vennelyst Blvd 6, Dk-8000 Aarhus C, Denmark. me@alm.au.dk
Christensen
Bo
B
Karlsmose
Bo
B
Lous
Jorgen
J
Lauritzen
Torsten
T
D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology; D005194:Family Practice; D005260:Female; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D011314:Preventive Health Services; D012307:Risk Factors; D012959:Socioeconomic Factors