Comparing five-year and ten-year predicted cardiovascular disease risk in Aotearoa New Zealand

national data linkage study of 1.7 million adults

Liang, Jingyuan
Wells, Susan
Jackson, Rod
Choi, Yeunhyang
Mehta, Suneela
Chung, Claris
Gao, Pei
Poppe, Katrina K

Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
Department of General Practice and Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
UC Business School, Accounting and Information Systems, University of Canterbury, Christchurch, New Zealand
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
Department of Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

Corresponding author: Jingyuan Liang, [email protected], Ph. +64 021627086

Received June 30, 2024

Received in revised form August 20, 2024

Accepted November 05, 2024

European Journal of Preventive Cardiology Publish Ahead of Print, November 07, 2024. | DOI: 10.1093/eurjpc/zwae361

Lay Summary

Given the lack of consensus on the optimal time horizon for predicting cardiovascular disease (CVD) risk to inform preventive treatment decisions, our study compared predicted 5-year and 10-year CVD risk in a national cohort of people without prior CVD.

5-year and 10-year CVD risk prediction equations selected largely the same people in the top risk quintile (rank-based comparison), however the overall median 10-year CVD risk was approximately 2.5 times the median 5-year risk. Consequently, common 5-year and 10-year guideline-recommended treatment thresholds (5% 5-year and 10% 10-year risk) identified different proportions of treatment-eligible individuals. Approximately twice as many men as women were identified as treatment-eligible regardless of the risk prediction horizon.
These findings indicate that recommended treatment thresholds, not how 5-year and 10-year equations rank individuals by risk, are the main determinant of treatment eligibility.

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