Change in cardiovascular risk assessment tool and updated Norwegian guidelines for cardiovascular disease in primary prevention increase the population proportion at risk: the Tromsø Study 2015–2016

• Published in: Open Heart
• Main Authors: Nilsen, Amalie, Hanssen, Tove Aminda, Lappegård, Knut Tore, Eggen, Anne Elise, Løchen, Maja-Lisa, Selmer, Randi Marie, Njølstad, Inger, Wilsgaard, Tom, Hopstock, Laila A
• Other Authors: Northern Norway Health Authority
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMJ 2021
• Subjects: Tromsø
• Online Access: http://dx.doi.org/10.1136/openhrt-2021-001777; https://syndication.highwire.org/content/doi/10.1136/openhrt-2021-001777

Aims To compare the population proportion at high risk of cardiovascular disease (CVD) using the Norwegian NORRISK 1 that predicts 10-year risk of CVD mortality and the Norwegian national guidelines from 2009, with the updated NORRISK 2 that predicts 10-year risk of both fatal and non-fatal risk of CVD and the Norwegian national guidelines from 2017. Methods We included participants from the Norwegian population-based Tromsø Study (2015–2016) aged 40–69 years without a history of CVD (n=16 566). The total proportion eligible for intervention was identified by NORRISK 1 and the 2009 guidelines (serum total cholesterol ≥8 mmol/L, systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥100 mm Hg) and NORRISK 2 and the 2017 guidelines (serum total cholesterol ≥7 mmol/L, low density lipoprotein (LDL) cholesterol ≥5 mmol/L, systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥100 mm Hg). Results The total proportion at high risk as defined by a risk score was 12.0% using NORRISK 1 and 9.8% using NORRISK 2. When including single risk factors specified by the guidelines, the total proportion eligible for intervention was 15.5% using NORRISK 1 and the 2009 guidelines and 18.9% using NORRISK 2 and the 2017 guidelines. The lowered threshold for total cholesterol and specified cut-off for LDL cholesterol stand for a large proportion of the increase in population at risk. Conclusion The population proportion eligible for intervention increased by 3.4 percentage points from 2009 to 2017 using the revised NORRISK 2 score and guidelines.