Coronary risk versus cardiovascular risk for treatment decisions in mild XXXX .

@entity1 @entity101 @entity65
BACKGROUND: British guidelines recommend treatment for mild @entity101 at a cardiovascular (CVD) risk threshold of 20% over 10 years. However, treatment is targeted at the equivalent coronary (CHD) risk of 15% over 10 years. We examined the relationship between CHD and CVD risk in @entity1 and @entity1 with mild @entity101 and assessed the accuracy of using a 10-year CHD risk threshold of 15% to identify @entity1 at a 10-year CVD risk > or = 20%. DESIGN: Cross-sectional survey of England in 1998. METHODS: We identified 5588 subjects aged 35-74 years free of @entity65 with complete data for risk assessment. Of these, 1364 (24.4%) had mild @entity101 (systolic pressure 140-159 mmHg or diastolic pressure 90-99 mmHg). The Framingham functions were used to estimate CHD and CVD event risk for each individual. RESULTS: At a 10-year CHD risk of 15%, the corresponding 10-year CVD risk for @entity1 and @entity1 , respectively was 20% and 21% in those aged < 55 years, and 24% and 25% in those aged > or = 55 years. Using a 10-year CHD risk threshold of 15% to identify @entity1 at a 10-year CVD risk > or = 20% had high specificity (>96%) in all four groups. For @entity1 and @entity1 respectively, the sensitivity was 73% (62-84%) and 62% (35-88%) in younger subjects, and 89% (85-93%) and 47% (38-56%) in older subjects. CONCLUSION: Using a 10-year CHD risk of 15% to target @entity1 at a 10-year CVD risk > or = 20% was reasonably accurate for @entity1 but missed about 50% of @entity1 eligible for antihypertensive treatment.
