title: Comparison of application of different methods to estimate lifetime cardiovascular risk.
abstract: BACKGROUND
  Recent guidelines recommend assessment of lifetime cardiovascular risk on the basis of traditional risk factors in adults who are not at high short-term risk. The aim of this study is to determine the implications of estimating the lifetime cardiovascular risk in individuals in a large occupational cohort in Spain.
  
  
  METHODS
  National cross-sectional study in an occupational cohort with an in-person interview including laboratory tests.
  
  
  METHODS
  Volunteer workers who were examined between January 2011 and December 2011 were included. A total of 580,236 workers were eligible during this year and 259,834 were examined (participation rate of 44.7%). Short-term (10-year) and lifetime cardiovascular risk were estimated using the American College of Cardiology (ACC) and the American Heart Association (AHA) tool and the QRISK2 and QRISK.
  
  
  RESULTS
  Sixty-eight per cent were male, mean age was 39 years, with an age range of 16 to 75 years. Total number of individuals included in this study was 258,676. The percentage of patients at high short-term risk was 6.85% (95% confidence interval (CI) 6.75%-6.95% and 20.83% (95% CI 20.60%-21.07%) with the QRISK2, and the ACC/AHA risk equations, respectively. Of the percentage of patients classified as not at high risk with the different tools 1.61% (95% CI 1.55%-1.66%) were high lifetime risk on QRISK, and 27.41% (95% CI 27.11%-27.70%) on ACC/AHA risk.
  
  
  CONCLUSIONS
  Application of lifetime cardiovascular risk engages greater numbers of individuals at high risk with substantial differences between the different methods available. These differences can have important clinical implications specifically in the percentage of candidates for lifestyle changes and eventually lipid lowering drugs.
authors.affiliation: Research Unit, Sardenya Primary Health Care Centre-Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain Teaching Unit of Family Medicine ACEBA, Barcelona, Spain cbrotons@eapsardenya.cat.
authors.forename: Carlos
authors.initials: C
authors.lastname: Brotons
authors.affiliation: Ibermutuamur, Madrid, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Calvo-Bonacho
authors.affiliation: Research Unit, Sardenya Primary Health Care Centre-Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain Teaching Unit of Family Medicine ACEBA, Barcelona, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Moral
authors.affiliation: Research Unit, Sardenya Primary Health Care Centre-Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain Teaching Unit of Family Medicine ACEBA, Barcelona, Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Puig
authors.affiliation: Sociedad de Prevención de Ibermutuamur, Madrid, Spain.
authors.forename: María T
authors.initials: MT
authors.lastname: Garcia-Margallo
authors.affiliation: Sociedad de Prevención de Ibermutuamur, Madrid, Spain.
authors.forename: María V
authors.initials: MV
authors.lastname: Cortés-Arcas
authors.affiliation: Ibermutuamur, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Catalina-Romero
authors.affiliation: Ibermutuamur, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Quevedo-Aguado
authors.affiliation: Instituto de Investigación, Hospital Universitario Doce de Octubre, Madrid, Spain.
authors.forename: Luis M
authors.initials: LM
authors.lastname: Ruilope
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008019:Life Style; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013030:Spain; D013997:Time Factors; D055815:Young Adult
chemical_list: D000960:Hypolipidemic Agents
keywords: Risk assessment; cardiovascular disease; risk factors