This article reports data that has already been published in Dutch . This has been reproduced in English, with permission from the copyright holder.
In the Netherlands (total population almost 17 million) more than 1 million people have cardiovascular disease, about 740.000 have diabetes and about 40.000 have chronic kidney disease ((pre)dialysis or transplantation) . Mortality rates due to ischaemic heart disease and stroke are low compared to the rest of Europe (top-3 and top-4, respectively) . Cardiovascular disease, diabetes mellitus and chronic kidney disease (further referred to as “cardiometabolic disease”) and cardiovascular mortality are highly associated with modifiable lifestyle factors such as smoking, physical inactivity and poor diet [4, 5]. In the Netherlands, more than a quarter of the population currently smokes and about half of all people are overweight or obese [6, 7]. These risk factors, together with biomedical indices such as glucose and cholesterol levels, blood pressure level and the family history of cardiometabolic disease  generate a personal risk profile which predicts the future development of cardiovascular disease and diabetes mellitus. In addition, the metabolic syndrome, with the hypertriglyceridaemic waist as its most prominent clinical criterion, is a contributing factor to global cardiometabolic risk .
Self-tests for glucose and cholesterol assessments and home devices for measuring blood pressure have become commercially available , but in the Netherlands no evidence-based cardiometabolic screening program exists within current medical practice. So far, cardiometabolic risk assessment in primary health care has been directed at case-finding, and structured, programmatic prevention is lacking.
General practitioners report to have a positive attitude towards preventing cardiometabolic disease, but they emphasize that screening should be directed at the group of patients with the highest cardiometabolic risk . Therefore the Dutch College of General Practitioners, the National Association of General Practitioners and the Netherlands Society of Occupational Medicine together with three health foundations (Netherlands Heart Foundation, Dutch Diabetes Research Foundation and Dutch Kidney foundation) developed the guideline Prevention Consultation cardiometabolic risk (PC CMR) . The PC CMR is based on current evidence regarding cardiometabolic risk estimation and comprises of a stepwise approach. Based on an online risk estimation (first step), high risk patients are referred to the general practice (second step), where the risk profile is completed and appropriate interventions are initiated. The prototype of the PC CMR was implemented in 16 general practices throughout the Netherlands for a period of 6 months. Aims of the study were 1) to evaluate uptake rates of the two steps of the PC CMR; 2) to assess the rates of newly diagnosed patients with hypertension, hypercholesterolemia, diabetes and chronic kidney disease at risk for cardiometabolic disease; and 3) to explore reasons for non participation.