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Use CHD risk charts with caution, GPs told

GPs should use the Framingham coronary risk charts published in the BNF with caution because of flaws in the data that underpin them, NICE has concluded.

The institute's draft hypertension guidance expresses serious 're-servations' about the accuracy of the charts, which are a key tool used by GPs to decide which patients qualify for statins and other drugs under the national service framework for CHD.

The NICE guidance warns that the risk estimates only apply to patients without known heart disease and that the data have an ethnic white basis and 'may not transfer reliably to other racial and ethnic groups'.

It adds: 'Data are sparse for certain age-sex groups and estimates for these groups may be imprecise.'

The charts are based on the US Framingham heart study but the NICE group said similar cohort studies in other countries had produced significantly different risk predictions.

The guidance admits GPs have little option than to continue using the charts until a better alternative is developed.

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