Underprivileged at Greater Risk of Heart Disease

The tools to spot their risk are lacking, British study finds

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FRIDAY, Oct. 28, 2005 (HealthDay News) -- Manual laborers and people who live in low-income areas are less likely than more affluent people to receive cholesterol and blood-pressure-lowering treatment to prevent heart disease.

That's the conclusion of a British study of over 12,000 people published in the November issue of the British Journal of General Practice.

The researchers' explanation for the finding: Methods typically used to assess a person's risk for heart disease underestimate the actual level of coronary heart disease risk associated with elevated risk factor levels in these groups of people.

"Our results suggest that 4,196 people in the study, mainly from manual social classes, might have received preventative treatment, had the scoring method been properly calibrated for this high risk population. In fact, only 585 were eligible for treatment, leaving 3,611 people untreated," lead researcher Dr. Peter Brindle, of the University of Bristol, said in a prepared statement.

The Framingham risk score is used to identify people at high risk for heart disease. Patients above a set threshold are prescribed preventive treatments. However, the Framingham score may not be relevant to the British population, the study authors said. That's because the Framingham score is based on U.S. data more than 20 years old and didn't include people in areas with high levels of socioeconomic deprivation.

The 10-year British study found that, using the Framingham risk score, cardiovascular disease death risk was underestimated across the entire study population. However, the risk was underestimated by 48 percent among manual laborers, compared to 31 percent for people in non-manual jobs. The same difference was evident between people living in low-income areas and those who were more affluent.

"Two very practical implications arise from this study," study co-author Professor Graham Watt of Glasgow University said in a prepared statement.

"First, will nationally agreed clinical guidelines be adjusted to take account of the higher risks in people living in deprived areas? Second, if this is done, and the number of patients requiring preventive treatment is substantially increased, will general practices get the extra resources needed to treat, monitor and review these extra patients, ensuring they get the benefit of life-saving treatments?"

More information

The American Heart Association has more about heart disease risk factors.

SOURCE: University of Bristol news release, Oct. 27, 2005


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