New way to assess risk of heart disease in ethnic groups

A new web-based calculator will better assess the risk of heart disease in British black and minority ethnic groups. These groups are often wrongly assessed.

ETHRISK is for everyday use in the doctor’s surgery and other primary care settings. It has been developed by researchers at the University of Bristol to improve prediction of the heart disease risks of seven British black and minority ethnic groups.

Ethnic groups within Britain have a different risk of coronary heart disease (CHD) and cardiovascular disease (CVD), when compared with the general population in Britain. However, their risks are not being correctly assessed, due to the outdated method of calculation.

Dr Peter Brindle, lead author on the paper published online today in the BMJ journal Heart, said: “The ETHRISK calculator adjusts for ethnic groups and is based on a re-calibration of the Framingham risk equations. It provides a much more realistic assessment of the risk of having heart disease and stroke within a 10-year period, faced by an individual from one of these groups.

“Once the blood pressure and cholesterol measurements have been taken, the nurse or doctor can go online and plug in the numbers to get a more accurate risk score for that individual. ”

The recommended way of preventing heart disease involves using the Framingham risk score to identify high-risk patients. Patients above an agreed threshold are prescribed preventive treatments. However, the relevance of the Framingham score to the British population is uncertain, particularly when applied to ethnic groups, because the US data on which Framingham is based, are over 20 years old.

This means that people in some ethnic groups may not be picked up as being at high risk, while others are taking drugs unnecessarily since their risk is being over-estimated.

Professor Peter Weissberg, Medical Director of the British Heart Foundation which funded the study, said: “We have known for some time that some ethnic groups are at particularly high risk of cardiovascular disease and that applying the conventional rules to predict their future risk of a heart attack was probably underestimating that risk.

“The Bristol University group have produced a risk assessment tool that adjusts for ethnic origin. This should help doctors to address some of the current inequalities in the provision of preventive medicine to ensure that those at highest risk, regardless of their background, are identified and treated before they develop heart disease.”

The data on which the recalibration has been calculated included 3,778 men and 4,544 women, aged 35-54, from the Health Survey for England 1998/99, and the Wandsworth Heart and Stroke Study.