Abstract

Cardiovascular disease (CVD) remains the main cause of death in the WHO European Region. This review of systematic screening programmes for CVD risk factors and preclinical CVD across general populations is a second edition of a report published in 2021. It includes an updated literature search and a more comprehensive investigation of country-level specific screening programmes. This updated review includes final results from two studies which were ongoing in 2021. It also identified 10 new studies, but none of these met the inclusion criteria. It shows that screening for CVD risk factors does not lower CVD morbidity and mortality or health-care expenses. Screening for preclinical CVD slightly reduces mortality and negative outcomes related to abdominal aortic aneurysm; however, the results may be outdated owing to a decline in smoking and improved treatment. Screening for atrial fibrillation or screening for a mixture of risk factors and preclinical CVD has a marginal effect on morbidity and mortality. Serious adverse effects are observed, probably due to overdiagnosis and overtreatment. Most studies were conducted in western European countries. Future research could investigate possible benefits of screening in countries that have not yet been studied. Few countries have national screening programmes for CVD risk factors and preclinical CVD.

Contents

• ABBREVIATIONS
• ACKNOWLEDGEMENTS
• SCREENING TERMINOLOGY
• 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 CVD
  • 2.4. Countries implementing systematic screening programmes for CVD risk and preclinical CVD
• 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 CVD
  • 3.4. Future research
  • 3.5. Policy considerations
• 4. CONCLUSIONS
• 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
• REFERENCES

Suggested citation:

Jørgensen T, Rotar O, Juhl CB, Linneberg A. What is the effectiveness of systematic population-level screening programmes for reducing the burden of cardiovascular diseases? Second edition. WHO Health Evidence Network synthesis report, 78. Copenhagen: WHO Regional Office for Europe; 2024”.

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 decision-making 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 Management unit

The Noncommunicable Diseases Management unit of the WHO Regional Office for Europe works to close the gap between the eastern and western Member States of the WHO European Region in cancer, cardiovascular diseases, chronic respiratory diseases, diabetes and oral diseases. The Noncommunicable Diseases Management unit provides strategic direction, technical assistance, disease-specific advice and tailored support to Member States to build country capacity. By combining evidence and expertise, it supports countries in the implementation of priority interventions across the care continuum to, for example, build quality-assured screening programmes, increase compliance with care standards and improve service delivery models that advance objectives related to health system strengthening, people-centred health care and the achievement of universal health coverage.

ISSN 2789-9217 (print)

ISBN 978-92-890-6088-2 (PDF)

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Suggested citation. Jørgensen T, Rotar O, Juhl CB, Linneberg A. What is the effectiveness of systematic population-level screening programmes for reducing the burden of cardiovascular diseases? Second edition. WHO Health Evidence Network synthesis report, 78. Copenhagen: WHO Regional Office for Europe; 2024. Licence: CC BY-NC-SA 3.0 IGO.

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