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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.

The study

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.

The findings

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.’

BMJ 2013, online 3 April


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