Development and validation of a new algorithm for improved cardiovascular risk prediction

Heart disease or cardiovascular disease (CVD) is a leading cause of death worldwide. An individual’s risk of dying of CVD over the next 10 years can be calculated from scoring systems using factors such as age, weight and blood pressure. If one has a high score, interventions – such as medication for high blood pressure, weight loss or smoking cessation - can be undertaken to decrease the risk.

The scoring systems used in the US (ASCVD), Europe (SCORE2) and the UK (QRISK3) use similar variables. The authors reviewed recent research and identified seven factors in men and women (brain cancer, lung cancer, Down Syndrome, blood cancer, chronic obstructive pulmonary disease, oral cancer and learning disability) and two specific to women (history of preeclampsia or postpartum depression), that are not included in any of these three scoring systems. Using data from over five million women, researchers found that 0.2 percent had a history of preeclampsia or eclampsia and 1.0 percent had a history of postpartum depression. They calculated the hazard ratios (HR) - the probability of a death from CVD over a given time period in a group with the risk factor compared to the probability without the risk factor. In a medical study, a hazard ratio of two means that an individual in the treatment group is twice as likely to experience the event within a specified time period compared to someone in the control group who is unaffected. For a history of preeclampsia, the HR was 1.56 and for postpartum depression, 1.18. This compares to values of 2.90 for heavy smokers and 4.52 for Type 1 diabetes. Using a new algorithm called QR4 that includes the nine new variables for women (including preeclampsia), was statistically better at predicting cardiovascular mortality than the three systems above.

The researchers concluded that, while the difference is not large, using the new algorithm would improve cardiovascular risk prediction by classifying thousands more individuals as high risk of heart disease. This could enable healthcare providers to implement treatment and lifestyle changes early, potentially preventing many cardiovascular deaths.

Take home: Including a person’s history of preeclampsia and/or postpartum depression would improve the accuracy of algorithms used to predict the risk of death from cardiovascular disease over a period of ten years. It's important to inform your healthcare provider about your history of preeclampsia and/or postpartum depression. This can help identify your risk of heart disease earlier and facilitate the implementation of treatment and lifestyle changes, ultimately prolonging your life and reducing the risk of cardiovascular death. 

Link:https://pubmed.ncbi.nlm.nih.gov/38637635/

Citation:Hippisley-Cox J, Coupland CAC, Bafadhel M, Russell REK, Sheikh A, Brindle P, Channon KM. Development and validation of a new algorithm for improved cardiovascular risk prediction. Nat Med. 2024 May;30(5):1440-1447. doi: 10.1038/s41591-024-02905-y. Epub 2024 Apr 18. PMID: 38637635; PMCID: PMC11108771.

About Research Roundup

Each quarter, our team of science writers reviews the most current research studies related to hypertensive disorders of pregnancy and summarizes those studies of greatest interest and potential impact to our community, including research studies related to risk assessment, diagnosis, prevention, and treatment. Special thanks to our volunteer research team, including Dr. Sig-Linda Jacobson, Dr. Jennifer Mitchell, and Amanda Yang, who under the leadership of Dr. Elizabeth Sutton, make Research Roundup possible, and to our Patient Advisory Council, who reviews these materials from the patient perspective.