Rapid community "Healthy Heart" screening to identify people at high risk of cardiovascular events

Objectives To evaluate the proof-of-concept feasibility of identifying individuals at high risk of cardiovascular disease through community-based PocDoc Healthy Heart point-of-care screening in a large, ethnically diverse, disadvantaged real-world cohort in the United Kingdom. Methods Proof-of-concept, non-randomised, non-interventional real-world cardiovascular disease risk case finding study in adults aged 18 years or older in real-world communities across the United Kingdom. Main outcome measures were identification of individuals with high risk of cardiovascular disease, defined as QRISK3 score ≥10%; and individuals meeting the criteria for weight loss, smoking cessation, or hypertension management services. Results A total of 4,256 individuals (mean age 49 years, 57% male, 31% body mass index ≥30 kg/m 2 ) were included in the Primary Cohort. The Targeted Outreach and Workplace sub-cohorts comprised 1,970 and 756 individuals, respectively. In the Primary Cohort, 35% (1,486/4,256) had high (>5.0 mmol/L) total serum cholesterol, 10% were smokers, 10% met criteria for weight loss services and 19% met criteria for hypertension management services. QRISK3 scores were generated for individuals who had not previously had a cardiovascular disease event (~90% of screened individuals). A QRISK3 score ≥10% was found in 20% (784/3,842) of individuals in the Primary Cohort, 26% (457/1,743) in the Targeted Outreach sub-cohort, and 6% (41/701) in the Workplace sub-cohort. In the Primary Cohort, 60% (472/784) of individuals with a QRISK3 score ≥10% were not being treated with a lipid-lowering therapy at the time of testing. Conclusions In this proof-of-concept study, community-based point-of-care screening identified individuals with elevated cardiovascular risk and unmet cardiovascular risk management needs. These findings are hypothesis-generating and provide the rationale for further controlled studies with systematic follow-up and health-economic analyses to evaluate whether this approach can deliver improved clinical and system-level outcomes. Trial registration ClinicalTrials.gov NCT06258005