ArticleBMJ (Clinical research ed.)1995
Strategies for reducing coronary risk factors in primary care: which is most cost effective?
Article in BMJ (Clinical research ed.), 1995. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 88 citations in OpenAlex.
- Pooled it
- Economic evaluations of cholesterol-lowering drugs: a critical and systematic review.PharmacoEconomics · 2007Pooled it
- Economic evaluation of cholesterol-related interventions in general practice. An appraisal of the evidence.Journal of epidemiology and community health · 1998Pooled it
- The effect of a cardiovascular educational intervention on healthcare utilization and costs.The American journal of managed care · 2010Trial
- A randomized trial to evaluate the effectiveness of dietary advice by practice nurses in lowering diet-related coronary heart disease risk.The British journal of general practice : the journal of the Royal College of General Practitioners · 1997Trial
- Cost effectiveness of personal health education in primary care for people with angina in the greater Belfast area of Northern Ireland.Journal of epidemiology and community health · 1996Trial
- Costs and cost effectiveness of health checks conducted by nurses in primary care: the Oxcheck study.BMJ (Clinical research ed.) · 1996Trial
- A Proposed Strategy against Obesity: How Government Policy Can Counter the Obesogenic Environment.Nutrients · 2023Review
- Contribution of life course cardiovascular risk factors to racial disparities in dementia incidence.Frontiers in dementia · 2023Article
- Organised and opportunistic prevention in primary health care: estimation of missed opportunities by population based health interview surveys in Hungary.BMC family practice · 2020Article
- Should health insurers target prevention of cardiovascular disease? A cost-effectiveness analysis of an individualised programme in Germany based on routine data.BMC health services research · 2014Article
- Cost effectiveness of statins in coronary heart disease.Journal of epidemiology and community health · 2005Review
- [Which statin is more efficient? Concepts and applications in economic evaluation].Atencion primaria · 2000Article
- The cost-effectiveness of lipid lowering in patients with ischaemic heart disease: an intervention and evaluation in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2000Article
- Estimating cardiovascular risk for primary prevention: outstanding questions for primary care.BMJ (Clinical research ed.) · 2000Article
- Review
- Follow up care in general practice of patients with myocardial infarction and angina. Trial was underpowered.BMJ (Clinical research ed.) · 1999Article
- Preventing ischaemic heart disease in one general practice: from one patient, through clinical audit, needs assessment, and commissioning into quality improvement.BMJ (Clinical research ed.) · 1998Review
- Aspirin use in middle-aged men with cardiovascular disease: are opportunities being missed?The British journal of general practice : the journal of the Royal College of General Practitioners · 1997Article
- Simvastatin. A reappraisal of its cost effectiveness in dyslipidaemia and coronary heart disease.PharmacoEconomics · 1997Review
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the relative cost effectiveness of a range of screening and intervention strategies for preventing coronary heart disease in primary care. SUBJECTS: 7840 patients aged 35-64 years who were participants in a trial of modifying coronary heart disease risk factors in primary care.
designEffectiveness of interventions assumed and the potential years of life gained estimated from a risk equation calculated from Framingham study data.
main outcome measureThe cost per year of life gained.
resultsThe most cost effective strategy was minimal screening of blood pressure and personal history of vascular disease, which cost 310 pounds-930 pounds per year of life gained for men and 1100 pounds-3460 pounds for women excluding treatment of raised blood pressure. The extra cost per life year gained by adding smoking history to the screening was 400 pounds-6300 pounds in men. All strategies were more cost effective in men than in women and more cost effective in older age groups. Lipid lowering drugs accounted for at least 70% of the estimated costs of all strategies. Cost effectiveness was greatest when drug treatment was limited to those with cholesterol concentrations above 9.5 mmol/l.
conclusionsUniversal screening and intervention strategies are an inefficient approach to reducing the coronary heart disease burden. A basic strategy for screening and intervention, targeted at older men with raised blood pressure and limiting the use of cholesterol lowering drugs to those with very high cholesterol concentrations would be most cost effective.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.