Cardiovascular diseases (CVDs) are the number 1 cause of death globally, taking an estimated 17 million lives each year. Scientists have found the first evidence indicating that patients with CVD and risk factors such as hypertension are more likely to get COVID-19 or have a poor outcome. This creates an urgent need to effectively control CVDs and thereby reduce the healthcare and economic burden in the European Region.
Screening the population for CVD risk factors is a mechanism used by various countries in the European Region to identify and reduce the incidence of cardiovascular diseases. However, a recently published report of the WHO Health Evidence Network (HEN) coordinated by the WHO Regional Office for Europe, which synthesized several high-quality randomized controlled trials concluded that population-level screening for CVD risk factors has no effect on lowering CVD morbidity and mortality at a population level.
Based on the evidence synthesized in this report, the key considerations are to:
- review systematic population-level screening programmes for CVD risk and CVD risk factors (if such already exist), avoid initiating new analogous programmes and consider alternative methods for reducing the CVD burden;
- re-evaluate current systematic population-level programmes for screening for AAA, taking into account the changes in risk factors and improved treatment;
- await the results of current quality trials on the effectiveness of screening for other preclinical CVDs before considering the implementation of such programmes.
Reducing CVDs remains important for the whole European Region and globally. An effective CVD prevention programme incorporates multiple fiscal and policy strategies (including tobacco control, salt reduction and elimination of trans fats) as well as management of CVD risk factors, such as hypertension in primary health care, which can be effectively supported by WHO-recommended tools.
This HEN synthesis report is part of WHO’s initiative to increase the effectiveness of screening, maximize benefits and minimize harm, aimed at understanding the effectiveness of systematic population-level screening programmes for reducing the burden of CVD.
Dr. Oxana Rotar (Chief Researcher, Research Laboratory of Noncommunicable Diseases Epidemiology, Almazov National Medical Research Centre), who has been involved as an expert in WHO projects since 2016, was invited to review the results of studies on population-level screening in Russian and to write the report.