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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.
Hippisley-Cox J et al. Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: Prospective cohort study. BMJ 2017 May 23; 357:j2099. (http://dx.doi.org/10.1136/bmj.j2099)
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.