News

Experts warn that a single UK CVD assessment tool is needed

02-Jun-08

A single cardiovascular risk assessment tool is needed for the whole of the UK, experts have warned.

The call comes after NICE reversed its decision to recommend the use of QRISK in England and Wales in favour of the Framingham 10-year risk equations, while Scotland looks set to adopt its own risk assessment tool called ASSIGN.

NICE guidance on lipid modification was released last week after being delayed for months so the institute could consider the value of the QRISK tool that has been developed in UK general practice.

Draft NICE guidance in February favoured QRISK over Framingham. But NICE has U-turned and decided to stick with Framingham.

However, the institute appears to be undecided on the value of Framingham, stating that there was an urgent need to establish which score was the most acceptable for use in England and Wales.

The move spares practices a massive reconfiguration of computer systems and changes to current practice, but the recommendation reportedly goes against the advice of three international experts.

A spokeswoman for the Scottish Government said the ASSIGN tool had been piloted by practices in south-west Glasgow and would be rolled out across Scotland and made available to all practices as a web-based tool.

The new tool has been developed to take into account factors that are suited to Scotland such as deprivation levels.

However, some experts are warning against countries adopting their own risk tools pointing out that all tools will be inaccurate to some degree but it was important to have a consistent approach.

The NICE guidance also recommends statin therapy as part of the management strategy for the primary prevention of CVD for adults with a 20 per cent or greater 10-year risk of developing CVD.

Treatments should be initiated with simvastatin 40mg. If there are potential drug interactions, or simvastatin 40mg is contraindicated, a lower dose or alternative preparation such as pravastatin may be chosen.

Before offering drugs to reduce cholesterol levels, all other modifiable risk factors should be considered and their management optimised if possible.

Comment below and tell us what you think