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Cardiovascular risk scores and prescribing in diabetes

BMJ 2003; 326 doi: (Published 19 April 2003) Cite this as: BMJ 2003;326:882

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

  1. Jamie Smith, specialist registrar (,
  2. Roger Corrall, consultant physician
  1. Department of Diabetes and Endocrinology, Bristol Royal Infirmary, Bristol BS2 8HW
  2. Ninewells Hospital, Dundee DD19SY

    EDITOR—Hall et al describe the use of primary prevention risk tables in type 2 diabetes.1 We agree that targeting cardiovascular risk in diabetes is a priority, but their proposals imply an overreliance on risk scores as the sole determinant of cardiovascular risk assessment in diabetes. This approach might lead to withholding treatment in some people whose risk is underestimated by risk scores.

    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, is unscientific and flies in the face of epidemiological evidence …

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