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Epidemiology and policy
P1-284 Variation in estimated ten-year cardiovascular risk across four risk scoring tools in both a general population sample and an occupational setting
  1. D O O'Donovan1,
  2. S Byrne1,
  3. M Loughrey2,
  4. G Browne2,
  5. T Fitzgerald2,
  6. I Perry2,
  7. L Sahm1
  1. 1Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
  2. 2Department of Epidemiology, University College Cork, Cork, Ireland

Abstract

Introduction Several screening tools are now available to estimate 10-year risk of cardiovascular disease (CVD). This study aimed to quantify the differences in CVD risk estimates derived from four widely-used risk scoring tools: Framingham, QRISK2, ASSIGN and SCORE with each tool applied in both a primary care and an occupational screening setting.

Methods The primary care sample data were derived from a cross-sectional study of 1016 men and women aged 50–69 years (median age 59 years, 48.3% male), recruited from 17 primary care practice lists in the south of Ireland. The occupational sample data were derived from a sample of 311 workers, aged 20–63 years (median age 35 years, 72% male), mainly skilled IT and administrative staff, recruited in the workplace. All participants received a standard CVD risk assessment including smoking history and measurement of BP and lipid profile. High CVD risk was defined as 10-year risk >20% for Framingham, QRISK2 and ASSIGN, and >5% for SCORE.

Results In the primary care population the proportion of participants with high 10-year CVD risk ranged from 12.8% (QRISK2) to 33.1% (SCORE). In the occupational setting, the proportion of participants with either intermediate or high 10-year CVD risk ranged from 1.3% (SCORE) to 35.1% (Framingham).

Conclusion This study highlights significant differences between four widely-used CVD risk scoring tools. The differences largely reflect variation in the CVD end points (morbidity or mortality) and risk thresholds used in the tools. This is a potential source of difficulty and confusion for practitioners and policy makers.

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