Estimated 10-year cardiovascular risk in a British population: results of a national screening project

H. A. W. Neil, R. Perera, J. M. Armitage, A. J. Farmer, D. Mant, P. N. Durrington Reference: Int J Clin Pract, September 2008, 62, 9, 1322-1331 Linked Comment: Viljoen. Int J Clin Pract 2008; 62: 1300-3.

Summary

Objective: To estimate 10-year cardiovascular disease (CVD) risk using the risk equation and risk categories of the Joint British Societies' Guidelines on Prevention of Cardiovascular Disease in Clinical Practice (2005).

Methods: A cross-sectional CVD screening programme was conducted in 35 towns in Great Britain. In total, 27,776 men and 43,261 women aged at least 18 years were screened. The estimated 10-year risk of CVD was calculated and directly standardised to the population of Great Britain. Results: The age standardised combined prevalence of known CVD, diabetes, lipid-lowering or antihypertensive drug therapy, which preclude multifactorial risk assessment, was 18.0% for men and 18.1% for women.

CVD risk was calculated for 56,863 individuals, and the age-standardised prevalence of an estimated 10-year CVD risk < 10% was 42.7% (95% CI: 42.2-43.1) for men and 60.4% (95% CI: 60.1-60.7) for women; 10% to < 20% was 19.6% (19.1-20.0) and 15.6% (15.2-15.9); and ‡ 20% was 19.6% (19.1-20.0) and 6.0% (5.8-6.2) respectively. After aggregating known CVD, diabetes, antihypertensive or lipid-lowering drug therapy, or an estimated CVD risk of ‡ 20%, the combined standardised prevalence of high CVD risk for individuals aged 50 years or more was 74.1% (73.5-74.8) for men (n = 14,787) and 45.5% (44.8-46.2) for women (n = 24,400).

Conclusions: Using current risk thresholds, there is a substantial unmet need for primary prevention of CVD, particularly among middle-aged men. The results emphasise the scale of intervention that a strategy of individual risk assessment and pharmacological intervention requires.

Acknowledgements to HEART UK

The project was conducted under the auspices of the Hyperlipidaemia Education and Atherosclerosis Research Trust (HEART UK) and Professor Neil is its current Chairman.

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