Adding Systematic Family History Enquiry to Cardiovascular Disease Risk Assessment: Clinical Utility in Primary Care
Authors: John Robson, Julia Hippisley-Cox, Peter Brindle
Journal: Annals of Internal Medicine (2012)

Letters17 July 2012Adding Systematic Family History Enquiry to Cardiovascular Disease Risk Assessment: Clinical Utility in Primary CareJohn Robson, MD, Julia Hippisley-Cox, DM, and Peter Brindle, MDJohn Robson, MDFrom Centre for Health Sciences, Queen Mary's School of Medicine and Dentistry, London E1 2AT, United Kingdom; University of Nottingham, Nottingham NG7 2RD, United Kingdom; and Avon Primary Care Research Collaborative, Bristol BS1 3NX, United Kingdom.Search for more papers by this author, Julia Hippisley-Cox, DMFrom Centre for Health Sciences, Queen Mary's School of Medicine and Dentistry, London E1 2AT, United Kingdom; University of Nottingham, Nottingham NG7 2RD, United Kingdom; and Avon Primary Care Research Collaborative, Bristol BS1 3NX, United Kingdom.Search for more papers by this author, and Peter Brindle, MDFrom Centre for Health Sciences, Queen Mary's School of Medicine and Dentistry, London E1 2AT, United Kingdom; University of Nottingham, Nottingham NG7 2RD, United Kingdom; and Avon Primary Care Research Collaborative, Bristol BS1 3NX, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-2-201207170-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read the recent article by Qureshi and colleagues (1) with interest. We agree that a positive family history of ischemic heart disease in a first-degree relative younger than 60 years has a marked impact on future risk for major cardiovascular disease (1). In the United Kingdom, we developed QRISK2 (www.qrisk.org) (2), a new algorithm for cardiovascular risk prediction derived from 10.9 million person-years. It established that, for both men and women in all major ethnic groups and at all levels of social deprivation, positive family history is associated with an increased risk for cardiovascular disease. On ...References1. Qureshi N, Armstrong S, Dhiman P, Saukko P, Middlemass J, Evans PH, et al; ADDFAM (Added Value of Family History in CVD Risk Assessment) Study Group. Effect of adding systematic family history enquiry to cardiovascular disease risk assessment in primary care: a matched-pair, cluster randomized trial. Ann Intern Med. 2012;156:253-62. [PMID: 22351711] LinkGoogle Scholar2. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh A, et al. Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. BMJ. 2008;336:1475-82. [PMID: 18573856] CrossrefMedlineGoogle Scholar3. Nasir K, Budoff MJ, Wong ND, Scheuner M, Herrington D, Arnett DK, et al. Family history of premature coronary heart disease and coronary artery calcification: Multi-Ethnic Study of Atherosclerosis (MESA). Circulation. 2007;116:619-26. [PMID: 17646582] CrossrefMedlineGoogle Scholar4. Collins GS, Altman DG. An independent and external validation of QRISK2 cardiovascular disease risk score: a prospective open cohort study. BMJ. 2010;340:c2442. [PMID: 20466793] CrossrefMedlineGoogle Scholar5. National Institute for Health and Clinical Excellence. Lipid modification: Cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease. London: National Institute for Health and Clinical Excellence; 2008. Accessed at www.nice.org.uk/CG67 on 1 May 2012. Google Scholar Author, Article, and Disclosure InformationAuthors: John Robson, MD; Julia Hippisley-Cox, DM; Peter Brindle, MDAffiliations: From Centre for Health Sciences, Queen Mary's School of Medicine and Dentistry, London E1 2AT, United Kingdom; University of Nottingham, Nottingham NG7 2RD, United Kingdom; and Avon Primary Care Research Collaborative, Bristol BS1 3NX, United Kingdom.Disclosures: Drs. Robson and Brindle were previously members of the National Institute for Health and Clinical Excellence Guideline Development Group for Lipid Modification, of which Dr. Robson was Chair. Dr. Hippisley-Cox is Professor of Clinical Epidemiology at the University of Nottingham and co-Director of QResearch, a not-for-profit organization and joint partnership between the University of Nottingham and EMIS (leading commercial supplier of information technology for 60% of general practices in the United Kingdom). Dr. Hippisley-Cox is also director of ClinRisk, which produces open- and closed-source software to ensure reliable and updatable implementation of clinical risk algorithms. This work and any views expressed within it are solely those of the authors and not of any affiliated bodies or organizations. There are no other relationships or activities that could have influenced the submitted work. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffect of Adding Systematic Family History Enquiry to Cardiovascular Disease Risk Assessment in Primary Care Nadeem Qureshi , Sarah Armstrong , Paula Dhiman , Paula Saukko , Joan Middlemass , Philip H. Evans , and Joe Kai , for the ADDFAM (Added Value of Family History in CVD Risk Assessment) Study Group* Adding Systematic Family History Enquiry to Cardiovascular Disease Risk Assessment: Clinical Utility in Primary Care Nadeem Qureshi , Paula Dhiman , and Joe Kai Adding Systematic Family History Enquiry to Cardiovascular Disease Risk Assessment: Clinical Utility in Primary Care David Goff Metrics 17 July 2012Volume 157, Issue 2Page: 148KeywordsAlgorithmsCardiovascular disease riskCardiovascular diseasesForecastingInformation technologyLipidsMedical servicesPrimary careRisk managementStatins ePublished: 17 July 2012 Issue Published: 17 July 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...