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Controlling CVD in older British women spells a heavy workload

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A survey of more than 4000 older British women has concluded that appreciably more resources than estimated will be required for optimal management of cardiovascular risk factors and secondary prevention of cardiovascular disease (CVD).

The British women’s heart and health study showed that among 4286 women prevalences of disease and risk factors were higher than supposed. A fifth had CVD and half high blood pressure, 12% smoked, 27% were obese, and 21% were inactive. Half had a total cholesterol concentration ⩾6.5 mmol/l. Age adjusted odds of CVD was highest in Scotland and lowest in south England. The odds narrowed, but were not equivalent, after adjusting further for age, risk factors, socioeconomic class, and treatment.

Control of risk factors and secondary preventive measures in women with CVD seemed as governed by region, socioeconomic class, and age as by clinical need but was suboptimal everywhere, according to the prevalences of smoking (12%), uncontrolled blood pressure (33%), obesity (30%), and total cholesterol concentration ⩾5 mmol/l (90%) or aspirin or antiplatelet treatment (41%) or statin treatment (22%).

The study was modelled on the British regional heart study, and women aged 60–79 years were sampled similarly across 23 towns in Scotland, northern England, Midlands and Wales, and south England. Data were obtained from GP records, self completion and nurse administered questionnaires, and physical examination and testing.

The distribution of risk factors for CVD and their control in women aged 60 plus was not known accurately. This study set out to remedy this in a nationally representative sample.