Abstract

Cardiovascular diseases (CVDs) remain the main cause of death in the WHO European Region. This systematic literature review assesses whether systematic screening programmes for CVD risk factors and preclinical CVDs across general populations can lower the CVD burden in society. Based on several high-quality randomized controlled trials with large numbers of participants, the results clearly showed that screening for CVD risk factors has no effect on lowering CVD morbidity and mortality in society. Studies showed that screening for preclinical CVDs slightly reduces mortality and negative outcomes related to abdominal aortic aneurysm; however, these results may be outdated, as smoking has declined and treatment has improved since the studies were completed. Results on screening for atrial fibrillation and other preclinical CVDs have not yet been published. In summary, the current evidence indicates that screening for CVD risk factors does not reduce the CVD burden.

Contents

• ABBREVIATIONS
• ACKNOWLEDGEMENTS
• SUMMARY
• 1. INTRODUCTION
  • 1.1. Background
  • 1.2. Methodology
• 2. RESULTS
  • 2.1. Study characteristics
  • 2.2. Population-level screening for CVD risk and CVD risk factors
  • 2.3. Population-level screening for preclinical CVDs
• 3. DISCUSSION
  • 3.1. Strengths and limitations of this review
  • 3.2. Contextual factors in the WHO European Region related to screening programmes for CVD risk and CVD risk factors
  • 3.3. Contextual factors in the WHO European Region related to screening programmes for preclinical CVDs
  • 3.4. Future research
  • 3.5. Policy considerations
• 4. CONCLUSIONS
• REFERENCES
• ANNEX 1. SEARCH STRATEGY
• ANNEX 2. STUDIES EXCLUDED AFTER FULL-TEXT REVIEW
• ANNEX 3. RISK OF BIAS IN THE INCLUDED STUDIES
• ANNEX 4. DATA EXTRACTION
• ANNEX 5. DETAILED RESULTS OF THE META-ANALYSES

Suggested citation:

Eriksen CU, Rotar O, Toft U, Jørgensen T. What is the effectiveness of systematic population-level screening programmes for reducing the burden of cardiovascular diseases? Copenhagen: WHO Regional Office for Europe; 2021 (WHO Health Evidence Network (HEN) Evidence Synthesis Report 71).

The Health Evidence Network

The Health Evidence Network (HEN) is an information service for public health decision-makers in the WHO European Region, in action since 2003 and initiated and coordinated by the WHO Regional Office for Europe under the umbrella of the WHO European Health Information Initiative (a multipartner network coordinating all health information activities in the WHO European Region).

HEN supports public health decision-makers to use the best available evidence in their own decisionmaking and aims to ensure links between evidence, health policies and improvements in public health. The HEN synthesis report series provides summaries of what is known about the policy issue, the gaps in the evidence and the areas of debate. Based on the synthesized evidence, HEN proposes policy considerations, not recommendations, for policy-makers to formulate their own recommendations and policies within their national context.

The Noncommunicable Diseases Integrated Prevention and Control programme

The Noncommunicable Disease Integrated Prevention and Control programme of the WHO Regional Office for Europe has three main functions: leading the integrated response of policies to address noncommunicable diseases (NCDs) at the regional and country levels; managing the major NCDs (cardiovascular diseases, cancer, chronic respiratory diseases and diabetes) across the continuum of care from prevention to early detection, screening, diagnosis, treatment, rehabilitation, secondary prevention and end-of-life/palliative care; and leading the NCD health systems response. It focuses on priority action areas and interventions in order to achieve regional and global targets to reduce premature mortality, reduce the disease burden, improve the quality of life and make healthy life expectancy more equitable, as called for in the WHO strategies and action plans for NCD prevention and control in particular and for sustainable development in general.

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ISSN 2227-4316

ISBN 978 92 890 5537 6

© World Health Organization 2021

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Suggested citation. Eriksen CU, Rotar O, Toft U, Jørgensen T. What is the effectiveness of systematic population-level screening programmes for reducing the burden of cardiovascular diseases? Copenhagen: WHO Regional Office for Europe; 2021 (WHO Health Evidence Network (HEN) Evidence Synthesis Report 71).

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