Study backs use of new heart risk tool

A cardiovascular risk assessment tool specific to the UK population has proved its worth and should be adopted across the country, say its developers.

Dr Rubin Minhas
The QRISK algorithm, which has been developed from UK general practice data, has shown its worth in an independent validation study of more than a million UK patients.

Compared with Framingham, the tool developed in the US in the 1970s and still used in the UK, QRISK was better at classifying patients into high or low categories of cardiovascular risk.

Framingham over predicted risk by 23 per cent and QRISK under predicted by 12 per cent.

This could be important when deciding if people have a 20 per cent risk of a cardiovascular event in 10 years, thereby making them eligible for statin therapy.

Apart from being developed in the UK, QRISK also differs from Framingham by taking deprivation into account.

Depending on a pending NICE guideline on lipid modification, QRISK could be used instead of Framingham across the UK to assess cardiovascular risk.

Lead researcher Dr Peter Brindle, a GP and research and development lead for Bristol PCT, said: ‘NICE are deliberating on it now.’

Dr Brindle is a member of the guideline development group at NICE, which is expected to publish the guideline in January.

‘Whatever NICE do I suspect there will be a large number of people willing to use QRISk because of the problems with health inequalities in the UK,’ he said.

‘Continuing to use Framingham could exacerbate health inequalities.’

Kent GP Dr Rubin Minhas, CHD lead for Medway PCT, said: ‘Framingham now looks like a more inaccurate risk tool and QRISK could prevent hundreds of thousands if not millions of people being unnecessarily treated.’

However, independent evaluation by NICE is needed, he added.

But Professor Mike Kirby, member of the Primary Care Cardiovascular Society, said: ‘I don’t think it matters that much as long as people estimate risk. You’re just really drawing a line in the sand.’

Nevertheless, he added: ‘I think it is a good idea to use a UK cohort. It will depend on NICE.’

Heart 2007 Online

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