Cappuccio, Francesco P., Oakeshott, Pippa, Strazzullo, Pasquale and Kerry, Sally M.. (2002) Application of Framingham risk estimates to ethnic minorities in United Kingdom and implications for primary prevention of heart disease in general practice : cross sectional population based study. BMJ, Vol.325 (No.7375). ISSN 0959-535X

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Abstract

Objective To compare the 10 year risk of coronary heart disease (CHD), stroke, and combined cardiovascular disease (CVD) estimated from the Framingham equations. Design Population based cross sectional survey. Setting Nine general practices in south London. Population 1386 men and women, age 40­59 years, with no history of CVD (475 white people, 447 south Asian people, and 464 people of African origin), and a subgroup of 1069 without known diabetes, left ventricular hypertrophy, peripheral vascular disease, renal impairment, or target organ damage. Main outcome measures 10 year risk estimates. Results People of African origin had the lowest 10 year risk estimate of CHD adjusted for age and sex (7.0%, 95% confidence interval 6.5 to 7.5) compared with white people (8.8%, 8.2 to 9.5) and south Asians (9.2%, 8.6 to 9.9) and the highest estimated risk of stroke (1.7% (1.5 to 1.9), 1.4% (1.3 to 1.6), 1.6% (1.5 to 1.8), respectively). The estimate risk of combined CVD, however, was highest in south Asians (12.5%, 11.6 to 13.4) compared with white people (11.9%, 11.0 to 12.7) and people of African origin (10.5%, 9.7 to 11.2). In the subgroup of 1069, the probability that a risk of CHD >15% would identify risk of combined CVD >20% was 91% in white people and 81% in both south Asians and people of African origin. The use of thresholds for risk of CHD of 12% in south Asians and 10% in people of African origin would increase the probability of identifying those at risk to 100% and 97%, respectively. Conclusion Primary care doctors should use a lower threshold of CHD risk when treating mild uncomplicated hypertension in people of African or south Asian origin.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Heart -- Diseases -- Risk factors, Cerebrovascular disease -- Risk factors, Cardiovascular system -- Diseases -- Risk factors, Africans -- Health and Hygiene, South Asians -- Health and Hygiene
Journal or Publication Title:	BMJ
Publisher:	BMJ Group
ISSN:	0959-535X
Date:	30 November 2002
Volume:	Vol.325
Number:	No.7375
Identification Number:	10.1136/bmj.325.7375.1271
Status:	Peer Reviewed
Access rights to Published version:	Open Access
Funder:	Wandsworth Health Authority, South Thames Regional Health Authority, NHS Executive. Research and Development Directorate, British Heart Foundation, British Diabetic Association, Stroke Association (Great Britain)
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URI:	http://wrap.warwick.ac.uk/id/eprint/4351

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