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QRISK2 and Framingham scores both poor predictors of CV risk in ethnic minorities

QRISK2 and Framingham cardiovascular disease risk scores do not ‘perform consistently well’ in all ethnic groups, suggests recent UK research.

3821 participants were randomly selected from primary care lists. Participants were aged 40-69 at baseline. 49% of participants were white Europeans, 39% were South Asians and 16% were African Caribbeans. The main outcome measure was the participants’ first cardiovascular event.

During the 10-year follow-up period, 387 cardiovascular events occurred in men (14%) and 78 in women (8%). Both scores underestimated risk in European and South Asian women. QRISK2 and Framingham had an identical ratio of predicted to observed risk of 0.73 in European women. In South Asian women, the QRISK2 had a ratio of 0.52, with Framingham at 0.43.Both scores performed poorly in identifying high risk African Caribbeans – QRISK2 and Framingham identified only 10% and 24% respectively, of those who experienced cardiovascular events as high risk.

The researchers noted that ‘neither score performed consistently well in all ethnic groups’ and that ‘further validation of QRISK2 in other multi-ethnic datasets, and better methods for identifying high risk African Caribbeans and South Asian women, are required’.

Heart, online 1 November