Table 1

Characteristics of studies

Author and dateStudy designCountryRecipient of risk informationControl groupIntervention groupRisk score providedDuration of follow upOutcomes measuredQuality assessment*
Asimakopoulou (2008)20Before-after studyEnglandPatientNACalculation of CVD/stroke risk followed by explanation of risk and discussion about difference between patients’ perception and actual risk1, 5 or 10 year UKPDS V.2.06 weeksUnderstanding and recall of riskL
Avis (1989)21RCTUSAPatientBaseline interview and assessment of perceived risk then follow-up interview at 7–12 weeksBaseline interview, assessment of perceived risk and then health risk appraisal using one of four risk instruments and feedback on risk then follow-up interview at 7–12 weeksCDC/HRA;37 The Heart Test;38 RISKO;39 Determine Your Medical Age407–12 weeksChange in perceived riskL
Christensen (1995)22Before-after studyDenmarkPatientNAHealth examination with calculation of risk score and health talk with the GPRisk of coronary artery disease416 monthsChange in psychological well-beingL
Christensen (2004)23RCTDenmarkPatientBaseline questionnaireBaseline questionnaire plus health screening with written feedback from their GPs and either optional or planned health discussions with their GP (2 intervention groups)Risk of cardiovascular disease (modified from41)1 and 5 yearsChange in psychological well-beingL-M
Connelly (1998)24Before-after studyUKPatientNABaseline questionnaire and screening appointment with provision of risk score. Participants at high risk were offered an appointment with a nurse or GP to discuss in more detail 5-year risk of CHD based on Northwick Park Heart Study4210 days and 3 monthsChange in psychological well-being and anxietyM-H
Hanlon (1995)25RCTScotlandPatientHealth education (interview backed up by written information) or health education and feedback on serum cholesterolHealth education plus feedback on risk score or health education and feedback on serum cholesterol plus feedback on risk scoreDundee risk score435 monthsSelf-reported change in diet, alcohol and smoking cessation, reduction in plasma cholesterol, and reduction in risk scoreM
Hussein (2008)26Before-after studyUSAPatientNAProvision of 5-year CVD risk estimate in interview lasting approximately 5 min5-year Framingham riskImmediateAccuracy of risk perceptionM
Paterson (2002)27Before-after studyCanadaPatientNAA consultation lasting approximately 18 min with a GP working through a workbook covering CHD and the concepts of risk and the patient's absolute and relative risk10-year risk of a coronary event based on Framingham Heart Study44Mean 12.8±13.1 daysChange in perceived riskL
Persell (2013)28RCTUSAPatientUsual carePatients were mailed a risk message containing their personal CVD risk information and encouraging them to discuss risk-lowering options with their primary care physician10-year Framingham risk score9 and 18 months LDL cholesterol, BP, prescriptions for lipid-lowering or antihypertensive medication, smoking cessation and number of primary care physician contactsM
Price (2011)29RCTUKPatientTold their individual fasting glucose level, blood pressure and LDL cholesterol and whether they were elevated according to current guidelines±brief lifestyle advice interventionA 10-year cardiovascular risk estimate for current risk and ‘achievable risk’ calculated assuming current targets for systolic BP, LDL cholesterol, HbA1c and smoking cessation were met±brief lifestyle advice intervention10 year UKPDS V.3.0 risk of cardiovascular disease1 monthPhysical activity, 10-year CVD risk, weight, body fat percentage, BP, alcohol consumption, LDL, triglycerides, fructosamine, fasting glucose, 2 h glucose, vitamin C, cotinine, anxiety, quality of life, self-regulation, worry about future risk of heart attack, intention to increase physical activity and prescribingM-H
Qureshi (2012)30Before-after studyUKPatientNACardiovascular risk assessment then risk score along with lifestyle advice leaflet posted within 4 weeks. Participants with risk >20% offered appointment with their family physician or nurse 2 weeks later10-year JBS2 cardiovascular risk score6 monthsAnxiety score, self-reported fat and unsaturated fat intake, smoking status and stage of change for increasing exerciseM
Bucher (2010)31RCTSwitzerlandPhysicianPhysicians received booklet of evidence-based guidelines for the management of CHD risk factors and were advised in the booklet to access a website for CHD risk assessmentPhysicians received same booklet of evidence-based guidelines plus a risk profile for each patient on the patient charts10-year Framingham risk12–18 monthsChange in total cholesterol, blood pressure, Framingham risk score and initiation of medicationH
Hall (2003)32RCTScotlandPhysicianUsual care—physicians were unaware of ongoing studyDocumentation of New Zealand Cardiovascular score at the front of medical records5-year cardiovascular risk from New Zealand Cardiovascular score45Not givenChange in prescribing for diabetes, hypertension or lipid-lowering drugsM
Hanon (2000)33RCTFrancePhysicianBaseline measurement of BP and prescription of fosinopril followed by visits at 4 and 8 weeks at which physicians could add in hydrochlorothiazideAs for control group plus calculation of Framingham risk also given to physicians10 year Framingham risk8 weeksChange in blood pressure, number of patients with dual antihypertensive therapy and change in Framingham riskM
Grover (2007)34RCTCanadaPhysician and patientPhysicians attended full-day educational session. Patients received usual care with follow-up at 2–4 weeks and 3,6,9 and 12 monthsPhysicians attended the same full-day educational session. Patients were given a copy of their risk profile and then followed up at 2–4 weeks, 3,6,9 and 12 months10-year Framingham risk12 monthsChange in 10-year risk of CVD and probability of reaching lipid targetsM-H
Grover (2009)35RCTCanadaPhysician and patientPhysicians attended full-day educational session. Patients received usual care with follow-up at 2–4 weeks and 3,6,9 and 12 monthsPhysicians attended the same full-day educational session. Patients were given a copy of their risk profile and then followed up at 2–4 weeks, 3,6,9 and 12 months10-year Framingham risk12 monthsMean blood pressure threshold for intensifying antihypertensive treatmentM
Lowensteyn (1998)36RCTCanadaPhysician and patientPhysicians—1 h education meeting and a monthly newsletter. Patients—completed questionnaire about attitudes and knowledge surrounding CVD prevention and assessment of their current lifestyle and medical problemsPhysicians—same 1 h education meeting and a monthly newsletter plus received 2 copies of patients risk profile within 10 working days. Patients—completed same questionnaire and then invited back 2 weeks later when presented with risk8-year coronary risk from CHD Prevention Model and estimated ‘cardiovascular age’3–6 monthsPatient/physician follow-up decisions and changes in smoking, cholesterol, BP, BMI, 8-year coronary risk and cardiovascular ageL
  • *Low (L), medium (M), high (H).

  • BMI, body mass index; BP, blood pressure; CHD, coronary heart disease; CVD, cardiovascular disease; GP, general practitioner; HbA1c, glycated haemoglobin; LDL, low-density lipoprotein; NA, not available; RCT, randomised controlled trial.