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Hutton: 'GPs' IT systems will be replaced'

Emma Wilkinson rounds up the latest research on cardiovascular disease

UK doctors have developed a new model to adjust the Framlingham charts after quantifying a four-fold difference in CHD risk between different ethnic groups.

They claim the model, currently undergoing validation, is far more sophisticated than the 'simplistic' correction factors currently available and could significantly improve risk assessment in ethnic minority patients.

The study used data from the Bristol Cardiovascular

Risk Scoring Group to calculate prevalence ratios for Indian, Pakistani, Bangladeshi, Chinese and Caribbean groups.

Framingham risk scores were then multiplied by the prevalence ratios to estimate 10-year CHD incidence.

A 60-year-old Pakistani man had four times the risk of a CHD event than a 60-year-old man of Caribbean origin and twice the risk of the population in general (see box).

Lead researcher Dr Peter Brindle, clinical research training fellow in health services research at the University of Bristol and a GP in the city, said: 'Some ethnic groups are pretty much excluded from the risk assessment process. We don't have firm guidelines on what to do for people who don't fit the Framingham mould.

'This methodology requires refinement, but could result in improved identification of high-risk individuals in minority ethnic groups.'

The data, presented at last week's British Cardiac Society cardiovascular disease prevention conference in London, came as research exposed further flaws in the much criticised Framingham charts.

10-year CHD risk for

a 60-year-old man (%)

Ethnicity Non-smoker Smoker

Indian 17.5 29.4

Pakistani 20.7 34.2

Bangladeshi 20.9 34.5

Chinese 6.1 10.7

Caribbean 5.0 8.8

Population 12.6 21.5

(Risks assuming systolic BP 130mmHg, cholesterol 5.5mmol/l and HDL cholesterol 1.3mmol/l)

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