Use lower CHD risk thresholds for ethnic minorities

People of South Asian and African origin with uncomplicated mild hypertension risk being undertreated. Their risk of combined cardiovascular disease is greater than for white people, Cappuccio and colleagues (p 1271) found when they conducted a cross sectional survey in 1386 men and women aged 40-59 years. People of South Asian origin and those of African origin with mild uncomplicated hypertension should be treated when their 10 year risk of coronary heart disease is 12% and 10% respectively. Current guidelines state that the threshold for treatment is 15%, but this figure has been calculated from data on white people. Reducing the risk threshold for these ethnic minorities may reduce inequalities in the prevention of cardiovascular disease.

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Relevant Article

Application of Framingham risk estimates to ethnic minorities in United Kingdom and implications for primary prevention of heart disease in general practice: cross sectional population based study

Francesco P Cappuccio, Pippa Oakeshott, Pasquale Strazzullo, and Sally M Kerry
BMJ 2002 325: 1271. [Abstract] [Full Text] [PDF]