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Ethnic group differences in cardiovascular risk assessment scores

There are marked inequalities in cardiovascular disease (CVD) incidence and outcomes between ethnic groups. CVD risk scores are increasingly used in preventive medicine and should aim to accurately reflect differences between ethnic groups. Ethnicity, as an independent risk factor for CVD, can be accounted for in CVD risk scores primarily using two methods, either directly incorporating it as a risk factor in the algorithm or through a post hoc adjustment of risk. In a study published in the journal Ethnicity & Health, Andrew Dalton and colleagues compared these two methods in terms of their prediction of CVD across ethnic groups using representative national data from England.

They carried out a cross-sectional study using data from the Health Survey for England. We measured ethnic group differences in risk estimation between the QRISK2, which includes ethnicity and Joint British Societies 2 (JBS2) algorithm, which uses post hoc risk adjustment factor for South Asian men. They reported that the QRISK2 score produces lower median estimates of CVD risk than JBS2. They concluded that ethnicity is an important CVD risk factor. Current scoring tools used in the UK produce significantly different estimates of CVD risk within ethnic groups, particularly in South Asian men.Work to accurately estimate CVD risk in ethnic minority groups is important if CVD prevention programmes are to address health inequalities.

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