Cardiovascular disease risk prediction equations published in The Lancet

May 7, 2018, University of Auckland

University of Auckland academics have developed new equations to predict the risk of cardiovascular disease (mainly heart attacks and strokes) in New Zealanders that has just been published in the prestigious medical journal The Lancet.

The study is significant for New Zealanders as it is the first of its kind derived from local data and it has found that the prediction equations currently in use, which are based on US data, now substantially over-predict the risk of cardiovascular disease.

Lead author, Professor Rod Jackson of the University's School of Population health, says

"Our findings are very significant as unless risk of cardiovascular disease is estimated using equations from modern populations that represent the patients they are applied to, there could be substantial underestimation or overestimation of risk, and therefore substantial undertreatment or overtreatment, is likely."

The study, "Cardiovascular disease risk prediction equations in 400 000 primary care patients in New Zealand: a derivation and validation study", included people without prior cardiovascular disease, congestive heart failure, or significant renal disease who had their assessed by their GPs or practice nurses using PREDICT software during patient consultations. The software stores an anonymised copy of each patient's risk factor data that is then linked to national hospital and mortality databases.

The study is one of the largest of its kind in the world, including 401 752 New Zealanders aged 30–74 years at the time of their first PREDICT risk assessment. They were recruited between Aug 27, 2002, and Oct 12, 2015 and represented about 90 per cent of the eligible population, mainly in Auckland and Northland.

The mean follow-up was 4·2 years, and 15,386 (4 per cent) of the people included had a cardiovascular disease event during follow-up, with 1507 (10 per cent) being fatal events. The median 5-year risk of total cardiovascular disease events predicted by the new equations was only 2·3 per cent in women and 3·2 per cent in men, however Māori, Pacific, and Indian patients were at 13–48 per cent higher risk of cardiovascular disease than Europeans, and Chinese or other Asians were at 25–33 per cent lower risk of than Europeans. Risk also increased with increasing socioeconomic deprivation, which had a multiplying effect on risk for many Māori and Pacific people in particular.

Professor Jackson says that a Ministry of Health organised expert group on Cardiovascular assessment and management has already endorsed the new equations and that the Ministry of Health has agreed to support a national implementation programme. The new PREDICT equations will now replace older, overseas equations that are no longer relevant for the ethnically and socioeconomically diverse New Zealand population.

Explore further: Severe mental illness linked to much higher risk for cardiovascular disease

More information: Romana Pylypchuk et al. Cardiovascular disease risk prediction equations in 400 000 primary care patients in New Zealand: a derivation and validation study, The Lancet (2018). DOI: 10.1016/S0140-6736(18)30664-0

Related Stories

Severe mental illness linked to much higher risk for cardiovascular disease

May 12, 2017
An international study of more than 3.2 million people with severe mental illness reveals a substantially increased risk for developing cardiovascular disease compared to the general population.

Idiopathic thrombocytopenic purpura tied to higher CVD risk

January 9, 2018
(HealthDay)—There is an increased risk of developing cardiovascular disease (CVD) among patients with idiopathic thrombocytopenic purpura (ITP), especially those who undergo splenectomy, according to a study published online ...

Healthy lifestyle reduces cardiovascular risk after gestational diabetes, study shows

October 16, 2017
A history of gestational diabetes was associated with a modest higher long-term risk of cardiovascular disease in women in a new study, although the absolute rate of cardiovascular disease was low in the study's younger group ...

Analysis supports use of risk equations to guide statin therapy

March 29, 2014
In an analysis of almost 11,000 patients, an assessment of equations that help guide whether a patient should begin taking a statin (cholesterol lowering medication) found that observed and predicted 5-year atherosclerotic ...

Non-O blood groups associated with higher risk of heart attack

April 30, 2017
Having a non-O blood group is associated with a higher risk of heart attack, according to research presented today at Heart Failure 2017 and the 4th World Congress on Acute Heart Failure.

Electrocardiography may be useful in the prevention of cardiovascular disease, study suggests

August 4, 2016
Electrocardiography (ECG or EKG) may be helpful in measuring the risk of cardiovascular disease in asymptomatic individuals according to a study led by researchers at the Rollins School of Public Health at Emory University.

Recommended for you

Genetic analysis links obesity with diabetes, coronary artery disease

November 16, 2018
A Cleveland Clinic genetic analysis has found that obesity itself, not just the adverse health effects associated with it, significantly increases the risk of Type 2 diabetes and coronary artery disease. The paper was published ...

Non-coding genetic variant could improve key vascular functions

November 15, 2018
Atherosclerotic disease, the slow and silent hardening and narrowing of the arteries, is a leading cause of mortality worldwide. It is responsible for more than 15 million deaths each year, including an estimated 610,000 ...

Study of two tribes sheds light on role of Western-influenced diet in blood pressure

November 14, 2018
A South American tribe living in near-total isolation with no Western dietary influences showed no increase in average blood pressure from age one to age 60, according to a study led by researchers at Johns Hopkins Bloomberg ...

Heart failure patients shouldn't stop meds even if condition improves: study

November 13, 2018
(HealthDay)—There's bad news for heart failure patients with dilated cardiomyopathy who'd like to stop taking their meds.

Bypass beats stents for diabetics with heart trouble: study

November 13, 2018
(HealthDay)—People with both diabetes and multiple clogged heart arteries live longer if they undergo bypass surgery rather than have their blood vessels reopened with stents, according to follow-up results from a landmark ...

New treatment significantly reduces cardiovascular events when combined with statins

November 12, 2018
Statins are the most commonly used treatment for cardiovascular disease. Despite reducing certain risk factors, if triglyceride levels remain high with use of statins, there is still a significant risk for heart attack, stroke ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.