Intended for healthcare professionals


Is estimating lifetime cardiovascular risk useful?

BMJ 2010; 341 doi: (Published 31 December 2010) Cite this as: BMJ 2010;341:c7379
  1. Rod Jackson, professor of epidemiology,
  2. Andrew Kerr, head of cardiology, Counties Manukau District Health Board,
  3. Sue Wells, senior lecturer in epidemiology and quality improvement
  1. 1School of Population Health, University of Auckland, Auckland, New Zealand
  1. rt.jackson{at}

No, but forecasting short term risk throughout life is

One of the exercises we set our medical students when introducing clinical epidemiology is to present the risk profile of a middle aged man and ask them to estimate his risk of death. Eventually someone works out the answer—100%. Death is inevitable, it is when and how the patient dies that are important. So does the QRISK lifetime cardiovascular risk model described in the linked study by Hippisley-Cox and colleagues (doi:10.1136/bmj.c6624) have any more clinical relevance than the lifetime risk of death?1

The QRISK lifetime cardiovascular risk model was derived from the QResearch database, an ongoing extract of clinical and administrative data from electronic general practice records in England and Wales, dating back to 1994. The database has generated the world’s largest cardiovascular risk prediction cohort study, which now includes more than three million people aged 30-84 years. The linked study reports that one in two British women have an estimated lifetime cardiovascular risk of over 30% and one in 10 have a risk of 50% or more. For men the …

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