Patients with CVD risk under 15% unlikely to become high-risk 'even after 19 years'
Patients with cardiovascular risk of less than 15% have low probability of subsequently becoming high-risk, and can be left longer than currently recommended in guidelines before having their risk reassessed, conclude researchers.
Australian and Japanese researchers used cohorts from the Tokyo health check-up study and two Framingham studies – the original Heart Study and the Offspring study – to assess their probability for becoming high risk for cardiovascular disease, defined as a 10-year Framingham risk of 20% or greater over 19 years. All 17,612 patients were aged 30 to 74 years and had an estimated Framingham risk for cardiovascular disease within 10 years of less than 20% and were not receiving treatment to lower blood pressure or cholesterol levels.
Those with a baseline risk of less than 5%, 5% to less than 10% and 10% to less than 15% had a probability of crossing the treatment threshold of less than 10% at three, eight and 19 years follow-up. But patients in the 15 to less than 20% baseline risk group had a probability over 10% of crossing the treatment threshold at just one year follow-up.
What does it mean for GPs?
The authors concluded that the analysis showed patients with a 10-year cardiovascular risk of over 15% should be reassessed within a year, but for those with lesser risk levels ‘the interval between assessments can safely be longer than generally suggested, but this interval should depend on the assessed level of risk.’