Cardiovascular risk scores and prescribing in diabetes

doi:10.1136/bmj.326.7394.882

BMJ 2003;326:882 ( 19 April )

Letters

Cardiovascular risk scores and prescribing in diabetes

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

Authors' reply

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

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

EDITOR $---$ Hall et al describe the use of primary prevention risk tables in type 2 diabetes.¹ We agree that targeting cardiovascularrisk in diabetes is a priority, but their proposals imply an overrelianceon risk scores as the sole determinant of cardiovascular riskassessment in diabetes. This approach might lead to withholdingtreatment in some people whose risk is underestimated by riskscores.

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, isunscientific and flies in the face of epidemiological evidencewhich suggests that type 2 diabetes should be regarded as a diseasegroup for secondary rather than primary prevention.²

Using the Framingham equation to evaluate cardiovascular risk in diabetes entails caveats. These include a low baseline prevalenceof diabetes in the Framingham cohort and the omission from theequation of triglyceride concentration, an . . . [Full text of this article]

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Articles

Controlled trial of effect of documented cardiovascular risk scores on prescribing: L M L Hall, R T Jung, and G P Leese
BMJ 2003 326: 251-252. [Extract] [Full Text] [PDF]

Comparison of cardiovascular risk between patients with type 2 diabetes and those who had had a myocardial infarction: cross sectional and cohort studies: Josie M M Evans, Jixian Wang, and Andrew D Morris
BMJ 2002 324: 939. [Abstract] [Full Text] [PDF]