CVD prevention strategies for high-risk individuals may widen health inequalities

In a Policy Forum published this week in PLoS Medicine, Simon Capewell and Hilary Graham review different population strategies for preventing cardiovascular disease and conclude that screening and treating high-risk individuals may be ineffective and widen social inequalities. The authors conclude "there is evidence that CVD prevention strategies for screening and treating high-risk individuals may represent a relatively ineffective approach that typically widens social inequalities. In contrast, policy interventions to limit risk-factor exposure across populations appear cheaper and more effective; they could also contribute to leveling health across socioeconomic groups". The researchers suggest that all future strategies aimed at improving population health will merit rigorous evaluation of their potential impact on inequities.

Funding: SC and HG are funded by The Higher Education Funding Council for England (HEFCE). HEFCE had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: SC was Vice-Chair of the NICE Programme Development Group on Cardiovascular Disease Prevention in Populations. HG has long advocated policies to reduce social inequalities. This paper arises from discussions at NICE, but does not necessarily reflect the views of NICE.