Search tips
Search criteria 


Logo of bmjLink to Publisher's site
BMJ. 1994 January 29; 308(6924): 313–320.
PMCID: PMC2539278

Randomised controlled trial evaluating cardiovascular screening and intervention in general practice: principal results of British family heart study. Family Heart Study Group.


OBJECTIVE--To measure the change in cardiovascular risk factors achievable in families over one year by a cardiovascular screening and lifestyle intervention in general practice. DESIGN--Randomised controlled trial in 26 general practices in 13 towns in Britain. SUBJECTS--12,472 men aged 40-59 and their partners (7460 men and 5012 women) identified by household. INTERVENTION--Nurse led programme using a family centred approach with follow up according to degree of risk. MAIN OUTCOME MEASURES--After one year the pairs of practices were compared for differences in (a) total coronary (Dundee) risk score and (b) cigarette smoking, weight, blood pressure, and random blood cholesterol and glucose concentrations. RESULTS--In men the overall reduction in coronary risk score was 16% (95% confidence interval 11% to 21%) in the intervention practices at one year. This was partitioned between systolic pressure (7%), smoking (5%), and cholesterol concentration (4%). The reduction for women was similar. For both sexes reported cigarette smoking at one year was lower by about 4%, systolic pressure by 7 mm Hg, diastolic pressure by 3 mm Hg, weight by 1 kg, and cholesterol concentration by 0.1 mmol/l, but there was no shift in glucose concentration. Weight, blood pressure, and cholesterol concentration showed the greatest difference at the top of the distribution. If maintained long term the differences in risk factors achieved would mean only a 12% reduction in risk of coronary events. CONCLUSIONS--As most general practices are not using such an intensive programme the changes in coronary risk factors achieved by the voluntary health promotion package for primary care are likely to be even smaller. The government's screening policy cannot be justified by these results.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.9M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Fullard E, Fowler G, Gray M. Promoting prevention in primary care: controlled trial of low technology, low cost approach. Br Med J (Clin Res Ed) 1987 Apr 25;294(6579):1080–1082. [PMC free article] [PubMed]
  • Richmond RL, Austin A, Webster IW. Three year evaluation of a programme by general practitioners to help patients to stop smoking. Br Med J (Clin Res Ed) 1986 Mar 22;292(6523):803–806. [PMC free article] [PubMed]
  • Russell MA, Stapleton JA, Feyerabend C, Wiseman SM, Gustavsson G, Sawe U, Connor P. Targeting heavy smokers in general practice: randomised controlled trial of transdermal nicotine patches. BMJ. 1993 May 15;306(6888):1308–1312. [PMC free article] [PubMed]
  • Mant D, McKinlay C, Fuller A, Randall T, Fullard EM, Muir J. Three year follow up of patients with raised blood pressure identified at health checks in general practice. BMJ. 1989 May 20;298(6684):1360–1362. [PMC free article] [PubMed]
  • Ritchie LD, Currie AM. Blood pressure recording by general practitioners in north-east Scotland. Br Med J (Clin Res Ed) 1983 Jan 8;286(6359):107–109. [PMC free article] [PubMed]
  • Kurji KH, Haines AP. Detection and management of hypertension in general practices in north west London. Br Med J (Clin Res Ed) 1984 Mar 24;288(6421):903–906. [PMC free article] [PubMed]
  • Hayes TM, Harries J. Randomised controlled trial of routine hospital clinic care versus routine general practice care for type II diabetics. Br Med J (Clin Res Ed) 1984 Sep 22;289(6447):728–730. [PMC free article] [PubMed]
  • Tunstall-Pedoe H. The Dundee coronary risk-disk for management of change in risk factors. BMJ. 1991 Sep 28;303(6805):744–747. [PMC free article] [PubMed]
  • Shaper AG, Pocock SJ, Phillips AN, Walker M. A scoring system to identify men at high risk of a heart attack. Health Trends. 1987 May;19(2):37–39. [PubMed]
  • Shaper AG, Pocock SJ, Walker M, Cohen NM, Wale CJ, Thomson AG. British Regional Heart Study: cardiovascular risk factors in middle-aged men in 24 towns. Br Med J (Clin Res Ed) 1981 Jul 18;283(6285):179–186. [PMC free article] [PubMed]
  • DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986 Sep;7(3):177–188. [PubMed]
  • Donner A, Donald A. Analysis of data arising from a stratified design with the cluster as unit of randomization. Stat Med. 1987 Jan-Feb;6(1):43–52. [PubMed]
  • MacMahon S, Peto R, Cutler J, Collins R, Sorlie P, Neaton J, Abbott R, Godwin J, Dyer A, Stamler J. Blood pressure, stroke, and coronary heart disease. Part 1, Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet. 1990 Mar 31;335(8692):765–774. [PubMed]
  • Kolonel LN, Lee J. Husband-wife correspondence in smoking, drinking, and dietary habits. Am J Clin Nutr. 1981 Jan;34(1):99–104. [PubMed]
  • Pill R, French J, Harding K, Stott N. Invitation to attend a health check in a general practice setting: comparison of attenders and non-attenders. J R Coll Gen Pract. 1988 Feb;38(307):53–56. [PMC free article] [PubMed]
  • Difford F, Telling JP, Davies KR, Fornear JE, Reading CA. Continuous opportunistic and systematic screening for hypertension with computer help: analysis of non-responders. Br Med J (Clin Res Ed) 1987 May 2;294(6580):1130–1132. [PMC free article] [PubMed]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Group