Conclusions This review demonstrates the potential for multifactorial interventions aim ed at individuals selected by CVD risk scores for lowering CVD risk and mortality .
However , the majority of studies in this area do not provide an intensity of intervention which is sufficient in significantly reducing CVD mortality or vali date d CVD risk
Objectives The high prevalence of cardiovascular disease ( CVD ) and the increased cost of treatment have prompted strategies for the primary prevention of CVD in the UK to move towards the use of vali date d CVD risk scores to identify individuals at the highest risk .
There are no review s evaluating the effectiveness of this strategy as a means of reducing CVD risk or mortality .
This review summarizes current evidence for and against the use of vali date d CVD risk scores for the primary prevention of CVD .
Predicting risk of type 2 diabetes in England and Wales: prospective derivation and validation of QDScore
Objective To develop and vali date a new diabetes risk algorithm ( the QDScore ) for estimating 10 year risk of acquiring diagnosed type 2 diabetes  over a 10 year time period in an ethnically and socioeconomically diverse population . Design Prospect i ve open cohort study using routinely collected data from 355 general practice s in Engl and and Wales to develop the score and from 176 separate practice s to vali date the score . Participants 2 540 753 patients aged 25 - 79 in the derivation cohort , who contributed 16 436 135 person years of observation and of whom 78 081 had an incident diagnosis of type 2 diabetes ; 1 232 832 patients ( 7 643 037 person years ) in the validation cohort , with 37 535 incident cases of type 2 diabetes . Outcome measures A Cox proportional hazards model was used to estimate effects of risk factors in the derivation cohort and to derive a risk equation in men and women . The predictive variables examined and included in the final model were self assigned ethnicity , age , sex , body mass index , smoking status , family history of diabetes , Townsend deprivation score , treated hypertension , cardiovascular disease , and current use of corticosteroids ; the outcome of interest was incident diabetes recorded in general practice records . Measures of calibration and discrimination were calculated in the validation cohort . Results A fourfold to fivefold variation in risk of type 2 diabetes existed between different ethnic groups . Compared with the white reference group , the adjusted hazard ratio was 4.07 ( 95 % confidence interval 3.24 to 5.11 ) for Bangladeshi women , 4.53 ( 3.67 to 5.59 ) for Bangladeshi men , 2.15 ( 1.84 to 2.52 ) for Pakistani women , and 2.54 ( 2.20 to 2.93 ) for Pakistani men . Pakistani and Bangladeshi men had significantly higher hazard ratios than Indian men . Black African men and Chinese women had an increased risk compared with the corresponding white reference group . In the validation data set , the model explained 51.53 % ( 95 % confidence interval 50.90 to 52.16 ) of the variation in women and 48.16 % ( 47.52 to 48.80 ) of that in men . The risk score showed good discrimination , with a D statistic of 2.11 ( 95 % confidence interval 2.08 to 2.14 ) in women and 1.97 ( 1.95 to 2.00 ) in men . The model was well calibrated . Conclusions The QDScore is the first risk prediction algorithm to estimate the 10 year risk of diabetes on the basis of a prospect i ve cohort study and including both social deprivation and ethnicity . The algorithm does not need laboratory tests and can be used in clinical setting s and also by the public through a simple web calculator ( www.qdscore.org )
Conclusions This review demonstrates the potential for multifactorial interventions aim ed at individuals selected by CVD risk scores for lowering CVD risk and mortality .
However , the majority of studies in this area do not provide an intensity of intervention which is sufficient in significantly reducing CVD mortality or vali date d CVD risk
Objectives The high prevalence of cardiovascular disease ( CVD ) and the increased cost of treatment have prompted strategies for the primary prevention of CVD in the UK to move towards the use of vali date d CVD risk scores to identify individuals at the highest risk .
There are no review s evaluating the effectiveness of this strategy as a means of reducing CVD risk or mortality .
This review summarizes current evidence for and against the use of vali date d CVD risk scores for the primary prevention of CVD .