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Cambridge scientists help create new risk calculator for heart and circulatory disease that could save lives across Europe

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A risk calculator capable of improving predictions of who is at a high risk of heart and circulatory disease within a decade is now available for use in the UK and Europe, following research by University of Cambridge scientists.

It is believed the SCORE2 risk calculator will save many more people from potentially deadly heart attacks or stroke.

The new tool will help predict those most at risk of heart attack or stroke
The new tool will help predict those most at risk of heart attack or stroke

Those flagged by the gold standard tool as having an increased risk could be put on a personalised preventative treatment, such as statins, or be given lifestyle advice to help reduce their risk.

The risk calculator is due to be adopted in the upcoming European Guidelines on Cardiovascular Disease Prevention in Clinical Practice

Prof Emanuele Di Angelantonio, at the University of Cambridge British Heart Foundation (BHF) Centre of Research Excellence, said: “This risk tool is much more powerful and superior than what doctors have used for decades. It will fit seamlessly into current prevention programmes with substantial real-world impact by improving the prevention of cardiovascular diseases across Europe before they strike.”

Around 200 investigators were involved in the development of SCORE2, with researchers across Europe analysing data from nearly 700,000 participants across 45 studies.

Participants, who were mostly middle aged, had no prior history of heart and circulatory disease when they were recruited to the studies.

They were followed up over 10 years and 30,000 of them had a ‘cardiovascular event’ – including fatal or non-fatal heart attack or stroke.

The risk tool was statistically recalibrated using regional-specific cardiovascular and risk factor data from 10.8 million people.

This ensures it more accurately estimates cardiovascular risk for populations split into four European risk regions.

Known risk factors for heart and circulatory diseases, such as age, sex, cholesterol levels, blood pressure and smoking were used to develop the tool, which offers a much-needed upgrade on the previously used tool, which was developed using data from before 1986 and underestimated the cardiovascular risk in some countries.

SCORE2 takes account of current trends in heart and circulatory diseases, can predict both fatal and non-fatal conditions and is adaptable to countries with different levels of risk.

Cardiovascular risk among younger people will be better predicted by the tool, which will also improve how treatment is tailored for older people and those in high-risk regions across Europe.

Dr Lisa Pennells, who also works at Cambridge’s BHF Centre of Research Excellence, said: “This project was a highly collaborative effort that has brought together key experts and extensive data sources to develop improved risk prediction tools for cardiovascular disease for use across the UK and Europe.

“A key feature is that our calculators are relevant to current day rates of cardiovascular disease in different regions of Europe. Importantly, our methods allow them to be easily updated using routinely collected data in the future to ensure they stay relevant as trends in heart and circulatory diseases change.”

Prof Sir Nilesh Samani, medical director at the BHF and cardiologist, said: “Heart and circulatory diseases are the world’s biggest killers, impacting the lives of 7.6 million people across the UK alone.

“This new risk tool is a major advance and will save many more people from developing heart attacks, stroke and heart disease, all of which develop silently over many years and strike without warning. It will be the new gold standard for doctors to determine which patients are at the highest risk of these conditions, and enable tailored treatment and lifestyle advice to be given much earlier.”

The study was carried out by the SCORE2 Working Group and the European Society of Cardiology Cardiovascular Risk Collaboration. It was supported by organisations including the British Heart Foundation, the Medical Research Council, National Institute for Health Research Cambridge Biomedical Research Centre and Health Data Research UK.

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