Detection of clustering of cardiovascular risk factors during a single practice-based screening programme

The prevalence and pattern of clustering of coronary heart disease (CHD) risk factors was examined in 336 men and 341 women aged 25-64 years who voluntarily attended a screening programme in 1 single general practice. At least 1 CHD risk factor (hypercholesterolaemia >6.5 mmol/1; smoking; hypertension >160 mmHg systolic and/or >95 mmHg diastolic and/or current antihypertensive therapy; hyperfibrinogenaemia >3.6 g/l; dyslipidaemia-serum triglycerides >2.0 mmol/l and HDL cholesterol <1.0 mmol/l; glucose intolerance 2 hour post-75 g glucose load plasma glucose >7.8 mmol/l) was present in 49.2% of those screened. The prevalences of hypercholesterolaemia, hyperfibrinogenaemia, smoking, hypertension, obesity (BMI >30), dyslipoproteinaemia and glucose intolerance were respectively, 27.7%, 17.7%, 14.5%, 9.6%, 9.6%, 8.6% and 3.4%. Gender differences were recorded with smoking (p = 0.01) and hyperfibrinogenaemia (p<0.001) more common in women and more dyslipoproteinaemia (p<0.001) in men. Two or more CHD risk factors were present in 14.9% of cases, and clustering was more common with increasing body mass and age (p = 0.00001). Amongst those with hypercholesterolaemia, 21.8% had hyperfibrinogenaemia, 14.9% hypertension, and 9.9% had dyslipoproteinaemia; in those with hyperfibrinogenaemia 32.5% had hypercholesterolaemia, 20% were smoking, 15% had hypertension, and 11.7% had dyslipoproteinaemia. Of those with hypertension 43% had hypercholesterolaemia, 30% had hyperfibrinogenaemia, 20.6% had dyslipoproteinaemia and 15.4% were smoking. Screening for clustering of CHD risk factors should concentrate on older or overweight individuals in addition to those with previously identified CHD risk.