Comparison of risk factors for coronary heart disease among attenders and non-attenders at a screening programme.

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 examine differences in risk factors between attenders and non-attenders at such a coronary heart disease screening programme. The 2402 patients in the age range 25-55 years who attended the original health check were examined by a practice nurse, and a questionnaire about health issues was completed. A one in 10 systematic sample of the 1398 patients who did not attend the original screening programme were approached and after considerable effort 98 were persuaded to attend for the same examination and questionnaire analysis. The 98 non-attenders were found to 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 coronary heart disease and to smoke than attenders. They were less likely to be highly educated and to have an unacceptably high level of alcohol consumption. The results of this study suggest that clinics that invite patients to attend are likely to attract those with lower risk factor profiles. For coronary heart disease prevention to be effective there is a need to cater for patients opportunistically.