Is coronary risk an accurate surrogate for cardiovascular risk for treatment decisions in mild hypertension? A population validation

Journal of Hypertension
E J WallisP R Jackson

Abstract

To examine the relationship between coronary (CHD) and cardiovascular (CVD) risk in patients with uncomplicated mild hypertension and to determine the accuracy of using CHD risk > or = 15% over 10 years to identify for antihypertensive treatment those patients with CVD risk > or = 20% over 10 years as advised in recent British guidelines. Comparison of decisions made using CHD risk > or = 15% over 10 years calculated by the Framingham risk function and estimated using a simple table with CVD risk > or = 20% over 10 years. British population. People aged 35-64 years with uncomplicated mild systolic hypertension (SBP 140-159 mmHg, n = 624) from the 1995 Scottish Health Survey. Relationship between CHD and CVD risk. Sensitivity, specificity, positive and negative predictive values (PPV and NPV). CHD risk 15% over 10 years was equivalent to CVD risk 21% over 10 years. Exact CHD risk > or = 15% over 10 years had sensitivity 79%, specificity 98%, PPV 94% and NPV 93% in detecting CVD risk > or = 20% over 10 years. Use of the table to estimate CHD risk > or = 15% over 10 years gave sensitivity 88%, specificity 90%, PPV 76% and NPV 95%. CHD risk appears acceptably accurate for targeting treatment in mild hypertension. The risk assessmen...Continue Reading

Citations

Aug 16, 2002·Heart·Erica J WallisPeter R Jackson
Sep 21, 2010·QJM : Monthly Journal of the Association of Physicians·N D Weatherley, P R Jackson
Jun 2, 2005·Pharmacotherapy·Michael G MillerAbdul-Karim Elhabyan

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