General Cardiovascular Risk Profile for Use in Primary Care

General Cardiovascular Risk Profile for Use in Primary Care. The Framingham Heart - Studyhttp://circ.ahajournals.org/cgi/content/abstract/CIRCULATIONAHA.107.699579v1

"Background—Separate multivariable risk algorithms are commonly used to assess risk of specific atherosclerotic cardiovascular disease (CVD) events, ie, coronary heart disease, cerebrovascular disease, peripheral vascular disease, and heart failure. The present report presents a single multivariable risk function that predicts risk of developing all CVD and of its constituents. [...]
Conclusions—A sex-specific multivariable risk factor algorithm can be conveniently used to assess general CVD risk and risk of individual CVD events (coronary, cerebrovascular, and peripheral arterial disease and heart failure). The estimated absolute CVD event rates can be used to quantify risk and to guide preventive care." PMID: 18212285 [PubMed - as supplied by publisher] The full article should be available without subscription in about 11 months.

Meanwhile:

Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: prospective open cohort study - http://www.bmj.com/cgi/content/full/335/7611/136

"Conclusion QRISK performed at least as well as the Framingham model for discrimination and was better calibrated to the UK population than either the Framingham model or ASSIGN. QRISK is likely to provide more appropriate risk estimates to help identify high risk patients on the basis of age, sex, and social deprivation. It is therefore likely to be a more equitable tool to inform management decisions and help ensure treatments are directed towards those most likely to benefit. It includes additional variables which improve risk estimates for patients with a positive family history or those on antihypertensive treatment. However, since the validation was performed in a similar population to the population from which the algorithm was derived, it potentially has a "home advantage." Further validation in other populations is therefore required."

Comparison of mean values for variables by age and sex in the derivation cohort compared with health survey for England (year nearest to 1996 with risk factor measured). Mean high density lipoprotein levels from health survey were not available until 2003 -
http://www.bmj.com/content/vol335/issue7611/images/large/hipj488692.f1.jpeg

Frank
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