A coronary screening programme in general practice

Abstract

All male patients between the ages of 37 and 43 were selected from an age-sex register and invited to attend the surgery for coronary screening, which included medical history, family history, occupation, smoking habits, blood pressure, examination of the urine, measurement of weight and height, the taking of an electrocardiogram and chest x-ray, plus fasting blood levels of cholesterol, sugar, triglycerides, lipid electrophoresis, urea, and full blood picture. Sixty-four per cent responded to the invitation and of those, avoidable risk factors were found in 52 per cent.

Forty per cent of those reporting had not previously had their blood pressure recorded. Fifty-eight per cent had not had their urine examined, and 71 per cent had never had a chest x-ray.

Twenty per cent were found to have atypical electrocardiograms (mainly T-wave changes and ectopics) and 20 per cent had sufficiently elevated plasma lipids to justify further electrophoresis. Forty-four per cent of patients admitted to smoking more than 10 cigarettes daily.

Follow-up of the smokers one year later showed that 27 per cent had stopped smoking completely, 12 per cent had reduced their smoking by more than half, 54 per cent had not changed their smoking habits at all, five per cent had given up smoking but started again, and two per cent had either moved away or could not be traced.

I believe such a programme can readily be undertaken in the average general practice and can yield much useful information, such that it is possible to influence patients' smoking habits by advice.