Artac Macide, Dalton Andrew R H, Majeed Azeem, Huckvale Kit, Car Josip, Graley Clare, Millett Christopher
Department of Primary Care and Public Health, School of Public Health, Imperial College London , 3 Floor, Reynolds Building, St. Dunstan's Road, London, W6 8RP , UK.
JRSM Short Rep. 2012 Mar;3(3):17. doi: 10.1258/shorts.2011.011103. Epub 2012 Mar 19.
To assess the completeness of cardiovascular disease (CVD) risk factor recording and levels of risk factors in patients eligible for the NHS Health Check.
Cross-sectional study.
Twenty-eight general practices located in Hammersmith and Fulham, London, UK.
42,306 patients aged 40 to 74 years without existing cardiovascular disease or diabetes.
MEASUREMENT AND LEVEL OF CVD RISK FACTORS: blood pressure, cholesterol, body mass index (BMI), blood glucose and smoking status.
There was a high recording of smoking status (86.1%) and blood pressure (82.5%); whilst BMI, cholesterol and glucose recording was lower. There was large variation in BMI, cholesterol, glucose recording between practices (29.7-91.5% for BMI). Women had significantly better risk factor recording than men (AOR = 1.70 [1.61-1.80] for blood pressure). All risk factors were better recorded in the least deprived patient group (AOR = 0.79 [0.73-0.85] for blood pressure) and patients with diagnosed hypertension (AOR = 7.24 [6.67-7.86] for cholesterol). Risk factor recording varied considerably between practices but was more strongly associated with patient than practice level characteristics. Age-adjusted levels of cholesterol and BMI were not significantly different between men and women. More men had raised blood glucose, blood pressure and BMI than women (29.7% [29.1-30.4] compared to 19.8% [19.3-20.3] for blood pressure).
Before the NHS Health Check, CVD risk factor recording varied considerably by practice and patient characteristics. We identified significant elevated levels of raised CVD risk factors in the population eligible for a Health Check, which will require considerable work to manage.
评估符合英国国家医疗服务体系（NHS）健康检查条件的患者心血管疾病（CVD）危险因素记录的完整性以及危险因素水平。
横断面研究。
英国伦敦哈默史密斯和富勒姆的28家全科诊所。
42306名年龄在40至74岁之间、无现有心血管疾病或糖尿病的患者。
CVD危险因素的测量和水平：血压、胆固醇、体重指数（BMI）、血糖和吸烟状况。
吸烟状况（86.1%）和血压（82.5%）的记录率较高；而BMI、胆固醇和血糖的记录率较低。各诊所之间BMI、胆固醇、血糖记录存在很大差异（BMI为29.7 - 91.5%）。女性的危险因素记录明显优于男性（血压的调整后比值比[AOR]=1.70[1.61 - 1.80]）。在最不贫困的患者组中，所有危险因素的记录情况更好（血压的AOR = 0.79[0.73 - 0.85]），以及在已确诊高血压的患者中（胆固醇的AOR = 7.24[6.67 - 7.86]）。危险因素记录在各诊所之间差异很大，但与患者特征的关联比与诊所水平特征的关联更强。年龄调整后的胆固醇和BMI水平在男性和女性之间无显著差异。血糖、血压和BMI升高的男性比女性更多（血压方面，29.7%[29.1 - 30.4]，而女性为19.8%[19.3 - 20.3]）。
在NHS健康检查之前，CVD危险因素记录因诊所和患者特征而异。我们发现符合健康检查条件的人群中CVD危险因素升高水平显著，这需要大量工作来管理。
