BMJ 2001;323:999 ( 27 October )

Letters

Predicting risk of death from cardiovascular disease

    Which measurements are the most appropriate?
    Outcome prediction is hampered by methodological problems
    Individual cardiovascular risk cannot be predicted
    Authors' reply

Which measurements are the most appropriate?

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

EDITOR---I would like to predict the risk score for all patients in my practice aged 35 years or older as so clearly described in the article by Pocock et al.1 My enthusiasm invariably turns to disappointment when using risk scores because of the following six factors.

Age---Most of these studies stop at the age of 74. As a significant proportion of my patients are aged 75 and over, I feel cheated. Is there any possibility of extrapolating the risk scores to an older age?

Smoking---Should I include former cigarette smokers who have only recently stopped smoking; recent being, for example, during the past year?

Blood pressure---Which measurement do I use? The most recent measurement, the average of the last three measurements, the highest recorded measurement, the average of the three highest recorded measurements, or a measurement with the patient seated, standing, or ambulatory, or the patient's own measurement?

. . . [Full text of this article]
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Relevant Article

A score for predicting risk of death from cardiovascular disease in adults with raised blood pressure, based on individual patient data from randomised controlled trials
Stuart J Pocock, Valerie McCormack, François Gueyffier, Florent Boutitie, Robert H Fagard, and Jean-Pierre Boissel
BMJ 2001 323: 75-81. [Abstract] [Full Text] [PDF]

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