Impact on risk scores of different approaches to lipid measurement

Optimal strategies for monitoring lipid levels in patients at risk or with cardiovascular disease: a systematic review with statistical and cost-effectiveness modelling(2015)

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BackgroundThe risk of CVD can be assessed using tools such as QRisk2, 52 ASSIGN 54 and Framingham 1991, 53 all of which include the TC/HDL cholesterol ratio. As noted previously (see Chapters 1 and 5), the latest NICE guidance on lipid monitoring for primary prevention populations 2 recommends using such risk scores to estimate 10-year risk of developing CVD to identify patients at ‘high risk’and hence guide treatment decisions, such as the prescription of statins. The 2010 high-risk threshold was a 10-year risk of≥ 20%, with the choice of risk calculator left to the GP. Updated guidance in 2014 recommended lowering the treatment threshold to 10% and the use of QRisk2 52 to calculate risk. 56 The methods in this chapter therefore focus on 10-year CVD risk calculation using QRisk2, 52 and include both 10% and 20% risk thresholds.
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