Effectiveness and equity of serum cholesterol and blood pressure testing: a population-based study in Spain.
BACKGROUND
This study examined the effectiveness and equity of serum cholesterol and blood pressure testing in Spain.


METHODS
Data were taken from a household survey of 3680 persons of the Basque Country, a region in northern Spain. Analyses were performed using logistic regression, controlling for need, equity, and predisposing factors for serum cholesterol and blood pressure testing. Proxies for need were age, subjective health and cardiovascular risk factors, such as tobacco and alcohol consumption, physical activity at work and at leisure time, and body mass index. Proxies for equity were sex, educational level, and province of residence, and predisposing factors for testing were the marital status and the number of medical visits in the preceding year.


RESULTS
The percentage of subjects that had their cholesterol measured rose with age and worse subjective health, but showed no association with any cardiovascular risk factor except body mass index, for which a positive association was observed (P for linear trend, 0.0351). The percentage of subjects with serum cholesterol checked also rose with educational level (P for linear trend, 0.0024). Moreover, women were less likely to have their cholesterolemia tested than men (OR, 0.79; 95% CI, 0.67-0.94). Educational and sex differences in cholesterol testing increased after adjustment for the number of medical visits. Similar results were obtained for blood pressure testing.


CONCLUSIONS
Serum cholesterol and blood pressure testing are not performed according to cardiovascular risk, which compromise its effectiveness. Moreover, there are social inequalities in testing, to which healthcare professionals could be contributing.
Rodríguez-Artalejo
Fernando
F
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain. fernando.artalejo@uam.es
Díez-Gañán
Lucía
L
Basaldua Artiñano
Ander
A
Banegas Banegas
José Ramón
JR
D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood*; D018672:Community Health Planning; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015397:Program Evaluation; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
D002784:Cholesterol