Large community health checks can identify heart disease risk

Pop-up screening for atherosclerotic cardiovascular disease (ASCVD) risk held at community pharmacies and large-scale sporting events can identify people with uncontrolled cardiovascular risk factors, according to a study published in JACC and simultaneously presented at the 73rd Annual Scientific Meeting of the Cardiac Society of Australia and New Zealand.

ASCVD is the leading cause of death worldwide but is often preventable in many cases. Regular preventive screenings can identify modifiable risk factors like elevated blood pressure (BP), elevated body mass index (BMI) and smoking, but many people aren’t participating in screenings or receiving recommended preventive care. Although preventive health checks have been shown to reduce rates of ASCVD, implementation on a large community scale has been limited.

“Heart health checks in the community can identify risk factors for future heart disease that can be managed by lifestyle changes or early preventive medications and save lives down the road,” said Professor Stephen Nicholls, senior author of the study and director of the Victorian Heart Institute, Monash University, Clayton, Victoria, Australia.

“We saw in this study that screening in a variety of places in the community not only works to identify risk but showed that different types of risk were more prevalent depending on screening location, screening day and screening time.”

In this study, researchers performed pop-up screenings at community pharmacies and an international cricket game to determine the number of participants who had uncontrolled cardiovascular risk factors.

Health stations were placed in 311 community pharmacies across Australia between Dec. 15, 2023 and Jan. 31, 2024. The health stations were available throughout the opening hours of each individual pharmacy, and screening performed before 5 p.m. was considered to take place during the daytime, while screening conducted after 5 p.m. was classified as evening.

The health stations were also available for nine hours a day during an international cricket match played daily between Dec. 26–29, 2023. Screenings were performed as part of the Shane Warne Legacy Health Test initiative in memory of Shane Warne, an Australian cricket icon who suffered a premature and sudden death in 2022. The screening initiative was widely promoted to the public in advance.

Over 76,000 people were screened throughout the seven-week study period, with 89.8% screened at community pharmacies and 10.2% screened at the cricket match.

Most participants were between 25 and 34 years old and male. Overall, 52,453 (68.9%) of participants met the primary outcome of having at least one uncontrolled risk factor: elevated BP reading, overweight or obese, or active smoker. Over one-third (37.2%) of participants with recorded BP readings were in the hypertensive range.

There were higher rates of having at least one uncontrolled risk factor found among those screened at the cricket match vs. pharmacies. Most participants were between the ages of 35 and 64 years old and male.

By individual risk factor, those at the cricket match had higher rates of elevated BP and BMI, but lower rates of smoking compared to those at pharmacies. About half of those with elevated BP readings had not had a BP check in the past year and over 80% were not on any antihypertensive medication.

At pharmacies, 24.3% were screened at rural pharmacies, where the majority were over 45 years old and had higher self-reported rates of diabetes. Most screenings took place on weekdays in the evening. Compared to urban community pharmacies, those screened in rural pharmacies had higher rates of all risk factors and self-reported diabetes. About half of those with elevated BP readings had not had a BP check in the past year and almost 70% were not on any antihypertensive medications.

“Pop-up screening can be creatively nested into community-based programs and events that are frequented by specific at-risk populations,” Nicholls said.

“These could direct screening efforts towards populations that could stand to benefit the most from ASCVD risk reduction while concurrently addressing disparities in access to health care.”