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Groups with high risk and not appropriate to risk with cardiovascular risk (CV risk) calculator

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • Framingham 1991 risk equations should not be used for people with pre-existing:
    • CHD or angina
    • stroke or transient ischaemic attack
    • peripheral vascular disease
  • Framingham risk equation should not be used for people who are already considered at high risk of CVD because of:
    • familial hypercholesterolaemia or other monogenic disorders of lipid metabolism
    • diabetes

  • CVD risk scores may not be appropriate as a way of assessing risk in people who are at increased CVD risk because of underlying medical conditions or treatments. These include people:
    • treated for HIV or with antipsychotic medication
    • people with autoimmune disorders such as systemic lupus erythematosus (SLE) and rheumatoid arthritis
    • people taking medicines that can cause dyslipidaemia such as antipsychotic medication, corticosteroids or immunosuppressant drugs

  • people with CKD (3)
    • offer atorvastatin 20 mg for the primary or secondary prevention of CVD to people with CKD
      • increase thedose if a greater than 40% reduction in non-HDL cholesterol is not achieved and eGFR is 30 ml/min/1.73 m2 or more
      • agree the use of higher doses with a renal specialist if eGFR is less than 30 ml/min/ 1.73 m2

Rheumatoid arthritis and cardiovascular risk:

  • data indicate that CVD mortality is increased by approximately 50% in RA patients compared with the general population (2)

Reference:

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