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Reproducibility of individualized coronary heart disease risk calculations in patients with diabetes mellitus

Lambert, A. P., Hunt, M. A., Day, A. P., Bayly, G. R. and Dayan, Colin Mark 2002. Reproducibility of individualized coronary heart disease risk calculations in patients with diabetes mellitus. Diabetic Medicine 19 (6) , pp. 514-517. 10.1046/j.1464-5491.2002.00687.x

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Abstract

Aims: To determine prospectively, the reproducibility of individualized coronary heart disease (CHD) risk estimations in a high-risk (diabetic) population. Methods: One hundred and three patients attending a hospital diabetes clinic who were in the primary prevention category for CHD had measurements of cholesterol, HDL-cholesterol and systolic blood pressure (SBP) performed in one of 13 general practices and then 2 weeks later in the hospital clinic. The data were combined with age, sex, smoking history and diabetic status data to produce a 10-year CHD risk estimate for each occasion using the Framingham algorithm. Results: The coefficients of variation for cholesterol, HDL and SBP were 6.0%, 9.4% and 7.0%, respectively. When classified by treatment thresholds of 15% and 30% 10-year CHD risk, 88% of patients were classified in the same category on both occasions. Kappa values for the 15% and 30% risk thresholds were 0.71 and 0.82. This indicates good interobserver agreement for the estimation of CHD risk. The use of a single BP rather than the mean of two, resulted in seven of 206 estimations of CHD risk performed in 103 patients crossing a risk threshold, with 6/7 being placed in a higher risk category. Conclusions: Estimation of CHD risk on a single occasion is sufficient to make robust treatment decisions based on risk thresholds. Use of a single BP measurement rather than the mean of two overestimates the risk category in around 3% of cases.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Systems Immunity Research Institute (SIURI)
Subjects: R Medicine > R Medicine (General)
Publisher: Wiley
ISSN: 0742-3071
Last Modified: 04 Jun 2017 06:41
URI: http://orca.cf.ac.uk/id/eprint/63667

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