In the linked study, Hippisley-Cox and colleagues develop and validate the second version of the QRISK cardiovascular disease risk algorithm (QRISK2), an attempt to more accurately estimate cardiovascular risk in patients from different ethnic groups in England and Wales.1

The advent of the first Framingham risk tables in the early 1990s was a challenge for most doctors. Since the second world war the management of cardiovascular risk has been part of the core business of general practice, but the single risk model dominated. Hypertension, diabetes, and hypercholesterolaemia were islands, each with its own experts fighting for bigger kingdoms by pushing for ever stricter boundaries and demanding more attention.

Framingham taught us to look at the different risk factors, and provided a major lesson: a cumulative average risk could be more important than one peak. Yet soon the extrapolation of these US tables to European populations seemed to overshoot the real risk in these groups.2 3 The SCORE tables …