Screening for cardiovascular risk in general practice

One of the most controversial components of the new contract imposed on British general practitioners in 1990 was the requirement to offer regular health checks to the public. This requirement came even though multiphasic health checks had been shown to be ineffective in terms of their impact on morbidity and mortality.1,2 During the 1970s case finding and health promotion had become to be regarded as options available to general practitioners during consultations,3 but during the 1980s the value of blanket (population) screening of all adults was disputed.4,5 The professional and scientific concerns were, nevertheless, ignored when the government required general practitioners (or their staff) to perform health checks of the population and also to identify cardiovascular risk factors for all adults and intervene appropriately.6 This week's BMJ publishes the early results of two large scale evaluations of health checks and interventions …