COMPARISON OF RISK-FACTORS FOR CORONARY HEART-DISEASE AMONG ATTENDERSAND NONATTENDERS AT A SCREENING-PROGRAM

Few objective comparative data are available from primary care on the prevalence of risk factors for coronary heart disease among those who do and do not attend screening programmes. This study set out to exami ne differences in risk factors between attenders and non-attenders at such a coronary heart disease screening programme. The 2402 patients i n the age range 25-55 years who attended the original health check wer e examined by a practice nurse, and a questionnaire about health issue s was completed. A one in 10 systematic sample of the 1398 patients wh o did not attend the original screening programme were approached and after considerable effort 98 were persuaded to attend for the same exa mination and questionnaire analysis. The 98 non-attenders were found t o be older and to have a higher mean body mass index, mean cholesterol level, mean systolic blood pressure and mean diastolic blood pressure than the 2402 attenders. The non-attenders were more likely to be in the lower social classes, to have a personal or family history of coro nary heart disease and to smoke than attenders. They were less likely to be highly educated and to have an unacceptably high level of alcoho l consumption. The results of this study suggest that clinics that inv ite patients to attend are likely to attract those with lower risk fac tor profiles. For coronary heart disease prevention to be effective th ere is a need to cater for patients opportunistically.