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09-12-2010 | Article

Lifetime score catches CV risk earlier

Abstract

BMJ

2010; Advance online publication

Using a lifetime risk score identifies patients at risk for developing cardiovascular disease (CVD) at younger age compared with a more conventional 10-year risk score, researchers report in the British Medical Journal.

"By identifying people at a younger age, GPs will have more chance of intervening before heart disease sets in, to help reduce their lifetime risk through treatments and lifestyle advice," commented lead author Julia Hippisley-Cox, professor of clinical epidemiology and general practice at the University of Nottingham.

The researchers used data for over 3.5 million patients from 563 general practices in the QResearch database to develop a QRISK score, which incorporates social deprivation and ethnicity, that estimates lifetime CVD risk.

Further analysis showed that just 14.5% of patients in the top centile of lifetime risk were also in the top centile for 10-year risk based on the QRISK2 score. Those who were at highest (top-centile) lifetime risk were much more likely to be younger, and also to be male, of non-White ethnicity, and to have a family history of coronary heart disease than those at highest risk by the 10-year QRISK2 score.

"Our study leaves a number of unanswered questions," cautioned Professor Hippisley-Cox.

These include whether early intervention in people at high lifetime risk but low 10-year risk would have a greater clinical benefit than later intervention, she added, and "determining the appropriate threshold for lifetime risk to balance the expected benefits against the potential adverse effects of interventions such as statins".

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Caroline Price