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

Authors


  • Disclosures PND and HAWN have served as consultants to pharmaceutical companies marketing lipid-lowering drugs, and PND, AJF and HAWN have received travel expenses, payment for speaking at meetings and funding for research from some of these companies. JMA has acted as an unpaid consultant to various pharmaceutical companies and has received reimbursement of costs to attend scientific meetings but has not accepted honoraria or other payments. RP has received unrestricted research funding from Unilever and DM received an honorarium for providing initial advice on the primary care aspects of this project.

H. A. W. Neil,
Division of Public Health and Primary Health Care, University of Oxford, Rosemary Rue Building, Old Road Campus, Headington, Oxford OX3 7LF, UK
Tel.:/Fax: + 44 1865 289258
Email: andrew.neil@wolfson.ox.ac.uk

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% (19.1–20.6) 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.

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