Details of participants
| Author and date | Study design | Inclusion criteria | Method of recruitment/randomisation | n (% of those eligible) | Age (years) | Gender (male) | Baseline CVD risk score |
|---|---|---|---|---|---|---|---|
| Asimakopoulou (2008)20 | Before-after study | Patients with type 2 diabetes free from cardiovascular, cerebrovascular or psychiatric comorbidity and able to understand English | Inspection of medical records then letter of invitation and randomisation to 1,5 or 10-year risk | 95 (66%) | Mean 64 (range 42–72) | 44% | Mean CHD 25% Mean stroke 15% |
| Avis (1989)21 | RCT | Adults 25–65 years with no history of CHD, diabetes or hypertension | Random digit dialling then randomisation to one of 4 risk appraisal tools | Control: 89 Intervention: 542 | NA | NA | Above average risk (risk ratio over 1.25): 36% |
| Christensen (1995)22 | Before-after study | 40–49-year-old men | Randomly selected from Public Health Insurance register then invited by GP | Low / moderate risk: 150 (81%) High risk 123 (73%) | 40–49 | 100% | NA |
| Christensen (2004)23 | RCT | 30–49 years old registered with local GP | Letter of invitation to random sample of those registered with local practice then randomisation into control and 2 intervention groups (combined for analysis) | Control: 501 (75%) Intervention: 905 (68%) | NA | NA | High risk (score>10): 11.4% |
| Connelly (1998)24 | Before-after study | Men aged 45–69 years with no obvious contraindications to antithrombotic therapy, no history of peptic ulceration or previous history of MI, stroke or serious psychiatric disorder | Search of medication records then letters of invitation | Baseline: 5772 (99%) 10 days: 4917 (85%) 3 months: 4244 (74%) | 45–69 | 100% | High risk (highest quintile): 18.4% |
| Hanlon (1995)25 | RCT | Workers at two work sites not working permanent night shifts, taking part in another coronary intervention or taking lipid-lowering medication | Random selection of workers then computer-generated randomisation | Control: 229 (78%) (HE only) and 226 (76%) (HE and feedback on cholesterol) Intervention: 214 (75%) (HE and risk) and 199 (76%) (HE, feedback on cholesterol and risk) | Control: 20–65 Intervention: 20–65 | NA | NA |
| Hussein (2008)26 | Before-after study | People with complete data available and no history of CVD events | Self-selection at 2 events of free stroke risk screening as part of a community health fair | 146 (80%) | Mean 47±15 | 36% | High risk (5%): 23.97% |
| Paterson (2002)27 | Before-after study | Age 30–74 years with measurements for blood pressure, smoking status, total and high-density lipoprotein cholesterol and free from cardiovascular disease | First 20 physicians who responded to letter of invitation. Physicians then enrolled 2 patients who met the study criteria and for whom they would be likely to use Heartcheck under normal practice conditions | 37 (92.5%) | 50±10.7 | 68% | Mean (SD): 10.8% (6.9) |
| Persell (2013)28 | RCT | Primary care physicians at an academic medical centre and patients aged 40–79 years without history of CVD, DM or PAD, not taking lipid-lowering medication who had 2 or more clinic visits in the preceding 2 years and LDL cholesterol test in previous 5 years with most recent LDL ≥100 mg/dL and 10-year FRS >20% or LDL ≥130 mg/dL and FRS 10–20% or LDL ≥160 mg/dL and FRS 5–10% | Medical record search then block randomisation at the level of the practice using random number generator | Control: 217 Intervention: 218 (93.6% across both control and intervention groups) | Control: 60.1±9.2 Intervention: 61.3±9.4 | Control: 77% Intervention: 77.5% | Mean (SD): 14% (6.5) |
| Price (2011)29 | RCT | Patients with CVD risk ≥20%, able to read and write English, not known to have CVD or a physical disability or other condition reducing the ability to walk | Eligible patients mailed written invitation and then factorial computerised randomisation | Control: 91 Intervention: 94 (16% across both control and intervention groups) | Control: median (IQR) 62.4 (56.0–65.9); Intervention: median (IQR) 62.3 (54.2–66.2) | Control: 71% Intervention: 64% | Median (IQR) men: 48% (34–60); women 31% (22–43) |
| Qureshi (2012)30 | Before-after study | Aged 30–65 years requesting a CVD risk assessment by their family physician without previous diagnosis of diabetes or CHD, stroke or PAD and not already receiving lipid-lowering medications or excluded by their physicians for psychological or social reasons | Usual practice | Control: 353 (92.9%) Intervention: 305 (80.3%) | Median 52 (45–58) | 39% | High risk (>20%): 11.4% |
| Bucher (2010)31 | RCT | Patients registered at the centres, not pregnant, aged 18 or older with continuous cART for 90 days prior to baseline and with complete data on CHD risk factors at baseline | Physicians randomised in strata according to patient volume and type of setting | Control physicians: 57 (71%) Control patients: 1682 (84%) Intervention physicians: 60 (71%) Intervention patients: 1634 (78%) | Control: median 44 (39–50) Intervention: median 44 (39–51) | Control: 64% Intervention: 68% | High risk (>20%): 3% |
| Hall (2003)32 | (R)CT | Patients 35–75 years with type 2 diabetes and no history of CVD or renal disease attending a hospital outpatient clinic | Consecutive recruitment of patients with alternate allocation to experimental and control group with doctors unaware of project | Control: 161 Intervention: 162 | NA | NA | High risk (>20%): 52% |
| Hanon (2000)33 | RCT | Adults 18–75 years with BP >140/90 without severe hypertension, secondary hypertension, heart disease, CVD, renal, pulmonary, hepatic disease or significant psychiatric or other serious illness, diabetes, pregnancy or of reproductive age without effective contraception | Recruited during usual care then randomised into 2 groups whether primary care physician had been told CVD risk | Control: 712 Intervention: 556 | Control: Mean 60±10 Intervention: Mean 60±10 | Control: 54% Intervention: 54% | Mean (SD): 25.4% (12.0) |
| Grover (2007)34 | RCT | Patients with diabetes or 10-year risk > 30% with moderate cholesterol, 10-year risk 20–30% with high cholesterol or 10-year risk 10–20% with very high cholesterol with no hypersensitivity to statins, risk of pregnancy, breastfeeding, active liver disease, raised CK or triglycerides, a history of pancreatitis or significant renal insufficiency* | Identified from office medical records or prebooked clinic appointments then randomisation stratified by risk level | Control: 1193 Intervention: 1163 (initial 98% recruitment) | NA | NA | Mean (SD): 17.8% (7.5) |
| Grover (2009)35 | RCT | As for Grover 200734 | Identified from office medical records or pre-booked clinic appointments then randomisation stratified by risk level | Control: 143 Intervention: 166 (initial 98% recruitment) | NA | NA | Mean (SD): 17.8% (7.5) |
| Lowensteyn (1998)36 | RCT | Interested primary care physicians around study centre. Patients 30–74 years without history of CVD in whom clinicians thoughts a risk profile would be clinically useful | Practices around study centre with block randomisation at the level of primary care practice according to presence or absence of medical school. Patients selected by physicians | Control physicians:32 (39%) Control patients: 176 Intervention physicians: 97 (57%) Intervention patients: 782 | Control: 50.7±11.3 Intervention: 50.0±10.8 | Control: 64.8% Intervention: 64.8% | Mean (SD): 10.5% (9.3) |
*Full criteria for inclusion were: 10-year risk >30% with LDL ≥97 mg/dL or TC:HDL ratio ≥4 or; 10-year risk 20–30% with LDL ≥116 mg/dL or a TC:HDL ratio ≥5 or; 10-year risk 10–20% with HDL-C ≥155 mg/dL or TC:HDL-C ratio ≥6; no hypersensitivity to statins, risk of pregnancy, breast feeding, active liver disease or elevated AST or ALT levels (>3 times normal), CK ≥5 times normal, elevated TGs (>939 mg/dL), a history of pancreatitis or significant renal insufficiency.
ALT, alanine transaminase; AST, aspartate transaminase; cART, combination antiretroviral therapy; CHD, coronary heart disease; CK, creatine kinase; CVD, cardiovascular disease; DM, diabetes mellitus; FRS, Framingham risk score; GP, general practitioner; HDL, high density lipoprotein cholesterol; LDL, low-density lipoprotein cholesterol; MI, myocardial infarction; NA, not available; PAD, peripheral arterial disease; RCT, randomised controlled trial; TC, total cholesterol; TG, triglyceride.