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Absolute CVD risk, stratified by risk score, was 20% higher in primary care patients with CVD than in those without CVD
Evidence-Based Medicine, 08/10/09

Lancaster T – Risk of cardiovascular disease (CVD) events increased with predicted risk category in primary care patients both with and without a history of CVD. Absolute risks were about 20 percentage points higher for patients with CVD, after adjusting for traditional risk factors.

Methods

Prospective cohort study with a mean 2 years of follow–up.
Patients: 35 760 patients 30–74 years of age (mean age 54 y, 57% men, 10% with a history of CVD) who had a CVD risk score calculated using the web–based PREDICT clinical decision support program.
Based on the Framingham risk score, PREDICT uses traditional CVD risk factors (age, sex, diabetes, smoking, blood pressure, and cholesterol concentrations) to classify patients as having <5%, 5% to <10%, 10% to <15%, 15% to <20%, or >=20% 5–year risk of a CVD event.
First CVD event (acute coronary syndrome, ischaemic or haemorrhagic stroke, peripheral arterial disease, a procedure for these conditions, heart failure, or death from CVD) after the PREDICT risk score was recorded (obtained by linkage with government databases).
Observed rates were extrapolated to 5 years, assuming constant incidence.

Results

Over the follow–up period, 1216 patients had >=1 CVD event, 42% of whom had a history of CVD.
Extrapolated 5–year event rates were 5.2% in patients without CVD at baseline and 29% in those with CVD.