Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New heart disease risk score will help minimise health inequalities

09.07.2007
A new score for predicting the risk of heart disease gives a more accurate measure of how many UK adults are at risk of developing the disease — and which adults are most likely to benefit from treatment.

The study, published on bmj.com on July 6, estimates that in the general population without pre-existing cardiovascular disease or diabetes, there are 3.2 million adults under the age of 75 in Britain at high risk of developing heart disease. This is lower than previous scores have suggested, but the researchers believe that it is a more appropriate estimate for the UK and will help minimise health inequalities.

The study comes as the government’s drugs watchdog, the National Institute for Health and Clinical Excellence, recommends that people with a 20 per cent chance of developing heart disease over the next 10 years should be offered statins.

A person’s chance of developing heart disease is estimated using standard risk factors such as age, sex, smoking, blood pressure and cholesterol. This risk score is typically based on equations derived from the US Framingham cohort study.

But the Framingham equations tend to over-predict heart disease risk in the UK population and fail to include measures of deprivation, family history of heart disease, body mass index, and treatment with blood pressure lowering drugs, despite known links between these factors and poor health.

So a team of researchers from The University of Nottingham, Bristol Primary Care Trust, and the Universities of Bristol and Queen Mary, set out to derive a new cardiovascular risk score (QRISK) for the UK and test its performance against the established Framingham score and a new a score used in Scotland called ASSIGN, which includes a measure of social deprivation.

The research has been conducted using data from a general practice research database called QRESEARCH, which is a joint partnership between the University of Nottingham and EMIS, a leading provider of IT systems to GPs.

The researchers tracked the progress of 1.28 million healthy men and women, registered at 318 general practices over a period of 12 years up to April 2007, recording first diagnosis of cardiovascular disease. All the participants were aged between 35 and 74 at the start of the study.

They found that the QRISK score was more accurate than either Framingham or ASSIGN. In patients aged 35-74, Framingham over-predicted cardiovascular disease risk at 10 years by 35%, ASSIGN by 36% and QRISK by 0.4%. QRISK predicted 9% of patients aged 35-74 years to be at high risk compared with 13% for the Framingham equation and 14% for ASSIGN.

Using this more focused tool for risk estimation, the research team estimate that 34% of women and 73% of men aged 64-75 would be at high risk compared with 24% and 86% according to the Framingham equation.

QRISK would also identify a different group of patients than the Framingham equation, with one in ten patients being reclassified into high or low risk, they say. QRISK is likely to provide more appropriate risk estimates of cardiovascular disease risk based on age, sex and social deprivation, write the authors. 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.

In people under 75 years without pre-existing cardiovascular disease or diabetes, QRISK identifies 3.2 million patients at high risk in 2005, compared with 4.7 million from Framingham and 5.1 million from ASSIGN.

They suggest that QRISK should be further tested in other populations, but point out that this is the largest such study to have ever been undertaken, and the first time routine data in a UK general practice population have been used in this way.

Study leader, Professor Julia Hippisley-Cox, of The University of Nottingham, said: “QRISK is derived from primary care data for use in primary care, and takes account of social deprivation to better identify patients most at most risk of heart disease and stroke who are most likely to benefit from treatment.

“We thank the many thousands of doctors who have enabled this research by freely contributing anonymised data to QRESEARCH, without which this work would not have been possible.”

Emma Thorne | EurekAlert!
Further information:
http://www.nottingham.ac.uk

More articles from Health and Medicine:

nachricht Penn vet research identifies new target for taming Ebola
12.01.2017 | University of Pennsylvania

nachricht The strange double life of Dab2
10.01.2017 | University of Miami Miller School of Medicine

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

Im Focus: How to inflate a hardened concrete shell with a weight of 80 t

At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).

Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...

Im Focus: Bacterial Pac Man molecule snaps at sugar

Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.

The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...

Im Focus: Newly proposed reference datasets improve weather satellite data quality

UMD, NOAA collaboration demonstrates suitability of in-orbit datasets for weather satellite calibration

"Traffic and weather, together on the hour!" blasts your local radio station, while your smartphone knows the weather halfway across the world. A network of...

Im Focus: Repairing defects in fiber-reinforced plastics more efficiently

Fiber-reinforced plastics (FRP) are frequently used in the aeronautic and automobile industry. However, the repair of workpieces made of these composite materials is often less profitable than exchanging the part. In order to increase the lifetime of FRP parts and to make them more eco-efficient, the Laser Zentrum Hannover e.V. (LZH) and the Apodius GmbH want to combine a new measuring device for fiber layer orientation with an innovative laser-based repair process.

Defects in FRP pieces may be production or operation-related. Whether or not repair is cost-effective depends on the geometry of the defective area, the tools...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

Nothing will happen without batteries making it happen!

05.01.2017 | Event News

 
Latest News

Multiregional brain on a chip

16.01.2017 | Power and Electrical Engineering

New technology enables 5-D imaging in live animals, humans

16.01.2017 | Information Technology

Researchers develop environmentally friendly soy air filter

16.01.2017 | Power and Electrical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>