Relevance of the Viborg Population Based Screening Programme (VISP) for Cardiovascular Conditions Among 67 Year Olds: Attendance Rate, Prevalence, and Proportion of Initiated Cardiovascular Medicines Stratified By Sex

Abstract

To report sex-specific overall attendance rate, prevalence of screening detected cardiovascular conditions, proportion of unknown conditions before screening, and proportion initiating prophylactic medicine among 67-year-olds in Denmark. Cross-sectional cohort study. Since 2014, all 67-year-olds in Viborg, Denmark, have been invited to screen for abdominal aortic aneurysm (AAA), peripheral arterial disease (PAD), carotid plaque (CP), hypertension, cardiac disease, and type 2 diabetes. Individuals with AAA, PAD, and/or CP are recommended cardiovascular prophylaxis. Combining data with registries has facilitated estimation of unknown screening detected conditions. Until August 2019, 5 505 had been invited; registry data were available for the first 4 826 who were invited. Attendance rate was 83.7%, without sex difference. Screening detected prevalence was significantly lower among women than men: AAA, 5 (0.3%) vs. 38 (1.9%) (p < .001); PAD, 90 (4.5%) vs. 134 (6.6%) (p = .011); CP, 641 (31.8%) vs. 907 (44.8%) (p < .001); arrhythmia, 26 (1.4%) vs. 77 (4.2%) (p < .001); blood pressure ≥ 160/100 mmHg, 277 (13.8%) vs. 346 (17.1%) (p = .004); and hbA1c ≥ 48 mM/M, 155 (7.7%) vs. 198 (9.8%) (p = .019), respectively. Pre-screening proportions of unknown conditions were particularly high for AAA (95.4%) and PAD (87.5%). Abdominal aortic aneurysm, PAD, and/or CP were found in 1 623 (40.2%), of whom 470 (29.0%) received pre-screening antiplatelets and 743 (45.8%) lipid-lowering therapy. Furthermore, 413 (25.5%) started antiplatelet therapy and 347 (21.4%) started lipid-lowering therapy. Only smoking was significantly associated with all vascular conditions in multivariate analysis: odds ratios (ORs) for current smoking were AAA 8.11 (95% CI 2.27 - 28.97), PAD 5.60 (95% CI 3.61 - 8.67) and CP 3.64 (95% CI 2.95 - 4.47). The attendance rate signals public acceptability for attending cardiovascular screening. Men had more screening detected conditions than women, but prophylactic medicine was started equally frequently in both sexes. Sex-specific (cost-) effectiveness follow up is warranted.