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

Marie Dahl; Jes Lindholt; Rikke Søgaard; Jens Refsgaard; Dorthe Svenstrup; Niels-Jørgen Moeslund; Mette Bredsgaard; Annette Høgh

doi:10.1016/j.ejvs.2023.03.014

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

Eur J Vasc Endovasc Surg. 2023 Jul;66(1):119-129. doi: 10.1016/j.ejvs.2023.03.014. Epub 2023 Mar 16.

Authors

Marie Dahl¹, Jes Lindholt², Rikke Søgaard³, Jens Refsgaard⁴, Dorthe Svenstrup⁴, Niels-Jørgen Moeslund⁵, Mette Bredsgaard⁶, Annette Høgh⁷

Affiliations

¹ Vascular Research Unit, Department of Vascular Surgery, Viborg Regional Hospital, Viborg, Denmark; Department of Clinical Medicine, Aarhus University, Denmark; Research Unit of Cardiac, Thoracic, and Vascular Surgery, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Denmark. Electronic address: marie.dahl@rm.dk.
² Vascular Research Unit, Department of Vascular Surgery, Viborg Regional Hospital, Viborg, Denmark; Research Unit of Cardiac, Thoracic, and Vascular Surgery, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Denmark; Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark; Elitary Research Centre CIMA, Odense University Hospital, Odense, Denmark.
³ Department of Public Health, Aarhus University, Denmark; Department of Clinical Medicine, University of Southern Denmark, Denmark.
⁴ Department of Cardiology, Viborg Regional Hospital, Viborg, Denmark.
⁵ General practice, Viborg Municipality, Viborg, Denmark.
⁶ Health Centre of Viborg Municipality, Viborg, Denmark.
⁷ Vascular Research Unit, Department of Vascular Surgery, Viborg Regional Hospital, Viborg, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.

PMID: 36931553
DOI: 10.1016/j.ejvs.2023.03.014

Abstract

Objective: To report sex specific overall attendance rate, prevalence of screen detected cardiovascular conditions, proportion of unknown conditions before screening, and proportion initiating prophylactic medicine among 67 year olds in Denmark.

Design: Cross sectional cohort study.

Methods: Since 2014, all 67 year olds in Viborg, Denmark, have been invited to screening 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 screen detected conditions. Up to August 2019, 5 505 had been invited; registry data were available for the first 4 826 who were invited.

Results: The attendance rate was 83.7%, without sex difference. Screen 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 mmol/mol, 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%). AAA, 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 multivariable 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).

Conclusion: The attendance rate signals public acceptability for attending cardiovascular screening. Men had more screen detected conditions than women, but prophylactic medicine was started equally frequently in both sexes. Sex specific cost effectiveness follow up is warranted.

Keywords: Abdominal aortic aneurysm; Cardiovascular disease; Carotid plaque; Peripheral arterial disease; Screening; Sex.

MeSH terms

Aortic Aneurysm, Abdominal* / diagnosis
Aortic Aneurysm, Abdominal* / epidemiology
Cardiovascular Diseases* / diagnosis
Cardiovascular Diseases* / epidemiology
Cross-Sectional Studies
Diabetes Mellitus, Type 2* / diagnosis
Diabetes Mellitus, Type 2* / epidemiology
Female
Humans
Lipids
Male
Mass Screening
Peripheral Arterial Disease* / diagnosis
Peripheral Arterial Disease* / epidemiology
Prevalence
Risk Factors

Substances

Lipids