Cardiovascular risk profile of English adults aged 30–84 years without existing cardiovascular disease by their eligibility and treatment status under the 2014 guidelines, estimated using data from HSE 2011a
| Total population aged 30–84 years and free of CVD, N= 29 936 (100%) | Receiving statins for primary prevention, N= 3522 (12%) | Eligible but not receiving statin therapy for primary prevention, N= 6305 (21%) | Receiving statins versus being eligible but not treated,b,c ORs (95% CIs) | |
|---|---|---|---|---|
| Female | 15 420 (52) | 1437 (41) | 2704 (43) | 1.09 (0.79 to 1.50) |
| Age, years | 50 (40–62) | 64 (55–72) | 67 (62–73) | 0.61 (0.52 to 0.73) |
| Ethnicity | ||||
| White or not stated | 27 286 (91) | 3280 (93) | 6028 (96) | Ref |
| South Asian or other Asian | 1457 (5) | 173 (5) | 214 (3) | 0.82 (0.35 to 1.90) |
| Other | 1193 (4) | 70 (2) | 63 (1) | 1.53 (0.51 to 4.62) |
| IMD, quintile | ||||
| 1 (least deprived) | 6827 (23) | 760 (22) | 1424 (23) | Ref |
| 2 | 6934 (23) | 827 (24) | 1479 (24) | 1.02 (0.68 to 1.53) |
| 3 | 6104 (20) | 735 (21) | 1370 (22) | 0.95 (0.64 to 1.41) |
| 4 | 5325 (18) | 637 (18) | 1171 (19) | 0.97 (0.62 to 1.53) |
| 5 (most deprived) | 4745 (16) | 564 (16) | 861 (14) | 0.93 (0.54 to 1.59) |
| Completed higher education | 7866 (26) | 519 (15) | 1008 (16) | 0.97 (0.62 to 1.49) |
| Urban resident | 22 896 (77) | 2580 (73) | 4579 (73) | 0.93 (0.65 to 1.32) |
| Total cholesterol, mmol/L | 5.4 (4.7–6.1) | 4.5 (3.9–5.3) | 5.8 (5.2–6.5) | – |
| HDL cholesterol, mmol/L | 1.5 (1.2–1.8) | 1.3 (1.1–1.6) | 1.4 (1.1–1.8) | – |
| Hypertension | 9234 (31) | 2365 (67) | 3632 (58) | 0.58 (0.36 to 0.94) |
| Systolic BP, mmHg | 124.5 (115–136) | 131.5 (122.5–143) | 134.5 (123.5–146) | – |
| Diastolic BP, mmHg | 73.5 (67–81) | 73.5 (67–80) | 74 (67–83) | – |
| Receiving BP medication | 4839 (16) | 1894 (54) | 2115 (34) | 3.30 (2.09 to 5.20) |
| Diabetes | 2283 (8) | 1181 (34) | 831 (13) | 2.66 (1.76 to 4.02) |
| Overweight, BMI ≥25–<30 kg/m2 | 12 536 (42) | 1351 (38) | 2905 (46) | 1.08 (0.72 to 1.61) |
| Obesity, BMI ≥30 kg/m2 | 7920 (27) | 1661 (47) | 1955 (31) | 1.23 (0.78 to 1.94) |
| Former smoker | 10 209 (34) | 1677 (48) | 2719 (43) | 1.07 (0.77 to 1.48) |
| Current smoker | 5620 (19) | 445 (13) | 1212 (19) | 0.46 (0.28 to 0.77) |
| 10-year CVD risk (QRISK2), %d | 4.3 (1.2–12.0) | 16.6 (10.2–25.1) | 18.4 (13.1–26.3) | – |
↵a Numbers are shown in thousands and per cent of population for categorical variables, and median and interquartile range for continuous ones. Numbers do not correspond to the column total for IMD quintile and for ethnicity in those receiving statins because of rounding.
↵b Odds ratios for receiving statins versus being eligible but not treated were estimated using a logistic regression model with the following independent variables: female sex, age (per 10 years), ethnicity (reference = white or not stated), Index of Multiple Deprivation quintile (reference = least deprived), completed higher education, urban resident, hypertension, receiving blood pressure medication, diabetes, weight status (reference = BMI <25 kg/m2), and smoking status (reference = never smoker).
↵c P-value (Wald test): ethnicity = 0.65, Index of Multiple Deprivation quintiles = 0.99, weight status = 0.62.
↵d The QRISK2 algorithm only permits total-to-HDL cholesterol ratios of up to 12, and BMI values ranging from 20 to 40 kg/m2. Therefore, in the estimation of 10-year CVD risk using QRISK2, total-to-HDL cholesterol ratios of >12 were set to 12 in two participants (out of the total 2972 participants), BMI values of <20 kg/m2 were set to 20 kg/m2 in 78 participants, and BMI values of >40 kg/m2 were set to 40 kg/m2 in 78 participants. BMI = body mass index. BP = blood pressure. CVD = cardiovascular disease. HDL = high-density lipoprotein. HSE = Health Survey for England. IMD = Index of Multiple Deprivation. OR = odds ratio. Ref = reference.