• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

How the Poor Are Missing Out on Treatment to Prevent Heart Disease

Posted on: Friday, 28 October 2005, 06:00 CDT

By CAMERON SIMPSON

PEOPLE living in deprived areas or working in manual occupations are less likely to get treatment to prevent heart disease, according to a new study.

The research at the universities of Glasgow and Bristol involved 12304 men and women from Renfrew and Paisley who were free from cardiovascular disease.

The Midspan Study started 10 years ago, and since then 696 people have died from cardiovascular disease when only 406 deaths were predicted through what is known as the Framingham risk score, used to identify high-risk patients.

One reason is the method underestimates the true level of coronary heart disease risk associated with elevated risk factor levels in these groups.

Peter Brindle, a researcher at Bristol University and a GP, said: "Our results suggest that 4196 people in the study, mainly from manual social classes, might have received preventative treatment, had the scoring method been properly calibrated for this high risk population.

In fact, only 585 were eligible for treatment, leaving 3611 untreated."

In the Framingham system, patients above an agreed threshold are prescribed preventive treatments.

However, the relevance of the Framingham score to the British population is uncertain:

because the US data on which it is based are more than 20 years old, and the original study did not include areas with high levels of socio-economic deprivation.

For people in manual occupations the risk was underestimated by 48-per cent, compared with 31-per cent for people in non-manual work. The same effect was observed comparing people living in affluent and deprived areas.

Because of the scoring methods underestimating risk, the study concludes preventive treatments are less available to the most needy.

Professor Graham Watt, of Glasgow University, said the study had two practical implications: "First, will nationally agreed clinical guidelines be adjusted to take account of the higher risks in people living in deprived areas?

"Second, if this is done, and the number of patients requiring preventive treatment is substantially increased, will general practices get the extra resources needed to treat, monitor and review these extra patients?"

Source: Herald, The; Glasgow (UK)

More News in this Category