Using risk tables to assess cardiovascular risk in type 2 diabetes has drawbacks

EDITOR—Hall et al describe the use of primary prevention risk tables in type 2 diabetes.1 We agree that targeting cardiovascular risk in diabetes is a priority, but their proposals imply an overreliance on risk scores as the sole determinant of cardiovascular risk assessment in diabetes. This approach might lead to withholding treatment in some people whose risk is underestimated by risk scores.

Unfortunately, the decision at what level of cardiovascular risk to start lipid lowering treatment in diabetes is not straightforward. The authors' oversimplistic approach, although convenient, is unscientific and flies in the face of epidemiological evidence …