QRISK3 Score Estimates 10-year Risk for Myocardial Infarction and Stroke

Summary and Comment |
June 22, 2017

QRISK3 Score Estimates 10-year Risk for Myocardial Infarction and Stroke

  1. Paul S. Mueller, MD, MPH, FACP

New risk factors have been added to the QRISK calculator.

  1. Paul S. Mueller, MD, MPH, FACP

QRISK, a calculator for estimating 10-year risk for myocardial infarction and stroke, is used across the British National Health Service (BMJ 2007; 335:136). Based on changes in England's population and research that has identified new cardiovascular (CV) risk factors, investigators derived and validated an updated calculator, QRISK3, in more than 10 million adults (age, 25–84). At baseline, patients did not have CV disease and were not taking statins.

QRISK3 includes all CV risk factors that were in QRISK2 (age, ethnicity, deprivation, systolic blood pressure, body-mass index, total-to-HDL cholesterol ratio, smoking, coronary heart disease in a first-degree relative younger than 60, presence of type 1 or type 2 diabetes, treated hypertension, rheumatoid arthritis, atrial fibrillation, and stage 4 or 5 chronic kidney disease). New independent CV risk factors in QRISK3 are stage 3 chronic kidney disease, systolic blood pressure variability, migraine, corticosteroid use, systemic lupus, atypical antipsychotic use, severe mental illness, and erectile dysfunction.

Comment

The QRISK3 calculator quantifies 10-year risk for myocardial infarction and stroke in British adults. QRISK3 hasn't been validated in populations outside of England, but it reminds us that many CV risk factors exist beyond traditional ones such as hypertension, hyperlipidemia, diabetes, and smoking.

Editor Disclosures at Time of Publication

  • Disclosures for Paul S. Mueller, MD, MPH, FACP at time of publication Consultant / advisory board Boston Scientific Editorial boards Medical Knowledge Self-Assessment Program; MKSAP 18 General Internal Medicine Leadership positions in professional societies American Osler Society (Board of Governors)

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