24 June 2008 New Cardiovascular score developed to improve heart attack and stroke detection A new and more accurate method of assessing people at risk from cardiovascular disease (CVD) is set to improve national diagnoses rates and identifies those at risk among black and minority ethnic groups. QRisk2, an equation developed to help doctors identify those most at risk of developing CVD for the first time, simultaneously takes into account extra risk from ethnicity, social deprivation and other clinical conditions such as family history of heart disease or diabetes. The study, to develop QRisk2, was undertaken by QResearch – a not-for- profit partnership between the University of Nottingham and leading primary care systems supplier, EMIS, that has created one of the world’s largest primary care databases. Dr Peter Brindle, Bristol Primary Care Trust researcher and research and development lead for Bristol, North Somerset and South Gloucestershire PCTs, co-authored the report. Doctors will be able to use this information to help decide how best to target patients with preventative measures such as lifestyle advice and cholesterol lowering treatments. The research reveals that certain ethnic groups are at much greater risk than the general population, with men of Pakistani background being nearly twice as likely to suffer a heart attack or stoke. For Bangladeshi men, the risk increases by nearly 70 per cent. The National Institute for Clinical Excellence (NICE) recommends that the Framingham equation, based on American data from a predominantly white population be modified, to take into account the increased risk in South Asian men. However, no adjustment is recommended for South Asian women. QRisk2 identifies the risk of CVD in this portion of the population, indicating that in Indian, Pakistani and Bangladeshi women, the risk is 43 per cent, 80 per cent and 35 per cent higher (respectively) than in the background population. Commenting on the research published in the BMJ today, Dr Brindle said: “Qrisk2 has been developed for GPs, by GPs. Without the co-operation of the thousands of working GPs and their patients who freely contribute their data to QResearch, projects like QRisk2 could not happen. “Based on the study of 15 years of data from over two million UK patients, QRisk2 is a contemporary and specific risk score that allows CVD risk to be personalised to the individual patient.” Dr Hugh Annett, Director of Public Health, Bristol, added that the new way to assess patients’ risk of cardiovascular disease will have important implications for local people: “One of Bristol Primary Care Trust’s key priorities is to reduce the health inequalities that mean there is a ten year gap in life expectancy between the most and least deprived parts of the city. We know that men, and for some health problems, men from Black and minority ethnic communities, have a greater risk of poor health. This important research offers us the chance to focus on those most likely to be at risk from cardiovascular disease.” The study comes as the Government’s health watchdog, NICE, recommends a systematic identification of people with a 20 per cent chance of developing heart disease in the next 10 years. The Government is investing an extra £500 million to support this work. -Ends- Notes • The QRisk2 report is available on www.bmj.com • QResearch is one of the world’s largest primary care databases, containing anonymised data from 11 million patients across the UK. New data is uploaded each night from the 551 EMIS general practices that participate in the project. The data is available for research to benefit public healthcare. Visit: www.qresearch.org • A team of researchers from the Universities of Nottingham, Edinburgh and Queen Mary’s and from Bristol and Medway Primary Care Trusts took part in the project. • For the first time, researchers gained a more detailed picture of the cause of death. The cause of death as recorded on the patient’s Office of National Statistics Online (ONS) death certificate was linked to the patient’s GP record for over 97 per cent of patients on the QResearch database who have died. This was done using NHS numbers dating back to 1993. • The QRisk2 model incorporates: Ratio of total serum cholesterol to HDL cholesterol; smoking; body mass index; family history of CVD, Townsend deprivation score; treated hypertension; rheumatoid arthritis; chronic renal disease; type 2 diabetes and atrial fibrillation. For more information contact: Alex Anderson @ Staniforth, 0161 919 8021, Alex.Anderson@staniforth.co.uk, or Libby Howard 07879 446277, firstname.lastname@example.org Or Carole Davis or Helen Drake EMIS marketing department on 0113 380 3498, or 0113 380 3497. Julia Hippisley Cox at the University of Nottingham 0115 8466915. Note to editors: Dr Peter Brindle is available for interviews. Contact Julie Hendry, Communications, Bristol PCT on 0117 9002549 to arrange.