Hospital Pharmacist
2007;14:216
July/August 2007

News summary

New measure for cardiac risk

Researchers have developed a new way of predicting the risk of developing heart disease that they say gives a lower, and more realistic, risk forecast than the currently accepted US Framingham algorithm or the recently developed Scottish ASSIGN score.

The new system includes variables such as social deprivation, body mass index, family history of heart disease and the effect of existing antihypertensive treatment, which are not included in the Framingham model.

Julia Hippisley-Cox, professor of clinical epidemiology and general practice at the University of Nottingham, and colleagues worked out their new QRISK system from the records of 1.28 million patients aged 35 to 74 years registered at 318 practices who had no record of diabetes or heart disease. They then validated it by looking at 610,000 patients from 160 other practices.

In the validation cohort the observed 10-year risk of a cardiovascular event was 6.60 per cent (95 per cent confidence interval 6.48 per cent to 6.72 per cent) in women and 9.28 per cent (9.14 per cent to 9.43 per cent) in men. Overall, the Framingham algorithm over-predicted cardiovascular disease risk at 10 years by 35 per cent, ASSIGN by 36 per cent and QRISK by 0.4 per cent.

“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,” the researchers say.

“QRISK is likely to provide more appropriate risk estimates to help identify high risk patients on the basis of age, sex and social deprivation.”