Risk in cardiovascular disease

doi:10.1136/bmj.321.7254.174

BMJ 2000;321:174 ( 15 July )

Letters

Risk in cardiovascular disease

Merit of using risk reduction rather than absolute risk for lipid lowering drugs

Joint British societies recommend their computer program for risk calculations

Absolute cardiovascular risk is not most appropriate measure to use

Having so many different guidelines about reducing risk is confusing

Subclinical hypothyroidism is risk factor for coronary heart disease

Merit of using risk reduction rather than absolute risk for lipid lowering drugs

The first 150 words of the full text of this article appear below.

EDITOR $---$ Our study of whether treatment recommendations for lipid lowering drugs should be based on absolute coronary risk orrisk reduction¹ was accompanied by an editorial by Jacksonin the same issue that warrants furtherdiscussion.

The chance of preventing a coronary event is the absolute risk multiplied by the relative risk reduction, but the questionis whether the relative risk reduction is equal in patients ofall ages. The meta-analysis of the statin trials by LaRosa etal,² cited as evidence for this by Jackson (together with threehypertension trials), does not render Law et al's meta-analysisof lipid lowering trials invalid³ as LaRosa et al includedboth primary and secondary prevention trials, assuming that thedifference between them relates only to the absolute risk of afurtherevent.

Our study concerned primary prevention, and the two relevant statin trials in this meta-analysis suggest that age may influence. . . [Full text of this article]

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Coronary and cardiovascular risk estimation for primary prevention: validation of a new Sheffield table in the 1995 Scottish health survey population: Erica J Wallis, Lawrence E Ramsay, Iftikhar Ul Haq, Parviz Ghahramani, Peter R Jackson, Karen Rowland-Yeo, and Wilfred W Yeo
BMJ 2000 320: 671-676. [Abstract] [Full Text] [PDF]

Should treatment recommendations for lipid lowering drugs be based on absolute coronary risk or risk reduction?: S Ramachandran, J M French, M P J Vanderpump, P Croft, and R H Neary
BMJ 2000 320: 677-679. [Full Text] [PDF]

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