In addition to identifying those patients with coronary heart disease, the National Service Frame-work also requires general practitioners to identify all people with a diagnosis of occlusive arterial disease, including stroke and peripheral vascular disease, and offer appropriate interventions. Asymptomatic peripheral vascular disease is common; it is estimated almost one in five patients between the ages of 55 and 74 would be identified as at risk. Patients with asymptomatic disease have the same increased risk of cardiovascular events and death as in patients with symptomatic disease. The author discusses how to diagnose asymptomatic disease, the merits of a screening programme in primary care, and which patients general practitioners should target.
For UK healthcare professionals only