IJCP: Despite increased CVD risk, middle-aged men more likely to go undiagnosed

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One in three people with a high risk of developing cardiovascular disease (CVD) over the next 10 years have not been diagnosed, according to a study in the September issue of the International Journal of Clinical Practice.

The shortfall in identifying people at high risk is greatest when it comes to middle-aged men, according to researchers, who examined more than 71,000 men and women. The study was carried out by Oxford University in Oxford, England, and funded by Unilever in London.

“The aim of our study was to estimate how many people were likely to develop CVD over the next ten years,” explained lead author Andrew Neil, MD, from the division of public health and primary care at Oxford.

The study suggests that 7.9 million people in the United Kingdom have already been diagnosed with CVD, or have a medically recognized risk of developing the disease in the next 10 years. However, the researchers noted that there are a further 2.8 million men and 900,000 women, who face a high risk but have not been diagnosed, meaning that they have not received the treatment and advice that could prevent them from developing CVD.

Neil and his research team screened 71,037 people aged 18 and older in 35 towns and cities in England, Wales and Scotland. They found that overall 20 percent of the men and six percent of the women had a high risk of developing CVD over the next 10 years.

The investigators found that the risk was much higher in patients older than age 50.

“We were reassured to discover that 60 percent of them had already been identified by their family doctor or another primary healthcare professional. However, the challenge now is to identify the other 40 percent who are at high risk of developing the disease but remain undiagnosed,” the authors wrote. 

"When we looked at gender differences in this age group, we found that only 47 percent of men had been identified as having a high CVD risk, considerably lower than the 72 percent of women identified, possibly because women are more likely to seek medical advice. These figures suggest that there is significant unmet need in the UK and points to the need for a national assessment program to detect those individuals who haven't already been identified,” according to Neil and colleagues.

The investigators made detailed notes on all the participants—regardless of prior diagnosis—and the 80 percent, who had not received any kind of diagnosis (56,863 people) were given a CVD risk assessment.

Researchers used the data collected by the nurses to estimate the 10-year CVD risk using the internationally recognized Framingham risk equation.