title: Methods for assessing cardiovascular disease risk in a UK black population.
abstract: OBJECTIVE
  To assess differences between cardiovascular disease (CVD) risk estimation methods when applied to a black UK population.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  51 GP practices in Lambeth, south-east London.
  
  
  METHODS
  26,370 black and 52,288 white registered patients aged 40-74 years.
  
  
  METHODS
  10-year CVD risk score estimates derived using Framingham, QRISK2, ASSIGN and ETHRISK algorithms. κ measures of agreement between risk scores and age-adjusted black/white mean risk ratios (RR) derived for each score.
  
  
  RESULTS
  There was a moderate agreement between the various risk scores for the black population (pooled κ 0.59 (95% CI 0.57 to 0.61) for men and 0.42 (95% CI 0.39 to 0.46) for women). For the white population, agreement was significantly improved (pooled κ 0.74 (95% CI 0.73 to 0.76) for men and 0.51 (95% CI 0.49 to 0.54) for women). Except for QRISK2, each method consistently overpredicted the CVD risk for the black population in comparison with national (Health Survey for England) prevalence figures. QRISK2 estimates were the least divergent from national data, giving a black/white mean RR of 0.73 (95% CI 0.71 to 0.74) for men and 0.85 (95% CI 0.83 to 0.87) for women.
  
  
  CONCLUSIONS
  The choice of risk estimation method does make a difference to estimates of CVD risk for black patients. The QRISK2 method, which incorporates ethnicity as a risk factor, appears to have the best fit with national data for this population.
authors: Division of Health and Social Care Research, Department of Primary Care and Public Health Sciences, King's College London, UK. peter.1.schofield@kcl.ac.uk
authors: Peter
authors: P
authors: Schofield
authors: Nicola
authors: N
authors: Crichton
authors: Rouling
authors: R
authors: Chen
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People / Q000208:ethnology*; D002318:Cardiovascular Diseases / Q000208:ethnology*; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods