Evidence map›Paper›PMID 40166609›Full record

ArticleBMJ public health2025

Optimal risk assessment intervals for primary prevention of cardiovascular disease: a population-based two-stage landmarking study.

Zander Gu, Francesca Gasperoni, Ellie Paige, Michael Sweeting, Juliet Usher-Smith, Katrina Poppe, David Stevens, Matthew Arnold, Emanuele Di Angelantonio, Angela M Wood and 1 more

Abstract read
In one paragraph

Article in BMJ public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. The Utility of Measures of Physical Behavior, Function, and Fitness as Predictors of Mortality.Mayo Clinic proceedings. Innovations, quality & outcomes · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Zander GuMRC Biostatistics Unit, University of Cambridge, Cambridge, UK.ORCID 0000-0001-7675-8000
Francesca GasperoniMRC Biostatistics Unit, University of Cambridge, Cambridge, UK.ORCID 0000-0002-1713-9477
Ellie PaigePopulation Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.ORCID 0000-0003-0855-9872
Michael SweetingUniversity of Leicester, Leicester, UK.ORCID 0000-0003-0980-8965
Juliet Usher-SmithPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.ORCID 0000-0002-8501-2531
Katrina PoppeDepartment of Medicine, University of Auckland, Auckland, New Zealand.ORCID 0000-0002-4418-4476
David StevensBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.ORCID 0000-0001-8874-7122
Matthew ArnoldBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.ORCID 0000-0001-6339-1115
Emanuele Di AngelantonioBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.ORCID 0000-0001-8776-6719
Angela M WoodBritish Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.ORCID 0000-0002-7937-304X
Jessica K BarrettMRC Biostatistics Unit, University of Cambridge, Cambridge, UK.ORCID 0000-0003-1889-9803

Funding

Wellcome Trust
6 · The paper itself

Abstract

Introduction: The recommended assessment intervals for primary prevention of cardiovascular disease (CVD) differ in major international guidelines. We aimed to provide empirical evidence on the optimal frequency of CVD risk assessment to inform future guidelines. Methods: We estimated the expected time to cross the 10-year CVD risk treatment threshold of 10% using extended two-stage landmarking for more than 2 million people using UK primary care electronic health records between April 2004 and May 2019 from the Clinical Practice Research Datalink GOLD Database (CPRD GOLD), which was linked to hospital admissions data from the Hospital Episodes Statistics (HES) dataset and national mortality records from the Office for National Statistics (ONS). We grouped people based on their sex, initial risk level and age, and computed various percentiles of the expected crossing times per group. Based on the percentiles, optimal assessment intervals were identified and their performance was evaluated comparing to the current recommended intervals in the UK. Results: Our results showed that the expected crossing times for people with lower initial risk were much longer than those with higher initial risk. Within each initial risk group, expected time to crossing the risk treatment thresholds was shorter in people aged ≥65 years. Based on the median expected crossing times, our recommended intervals for women with initial 10-year risk of 7.5%-10%, 5%-7.5%, 2.5%-5% or<2.5% are 3 (1 if ≥65 years old), 7 (4), 10 (6) and 10 (10) years, respectively; intervals for men are 2 (1), 5 (5), 9 (9) and 10 (10) years. These intervals outperformed the 5-yearly risk reassessment for all individuals currently recommended in the UK. Conclusions: Our evidence suggests that CVD risk assessment intervals for primary prevention should be stratified by sex, initial risk level and age. For the UK population, our method found risk assessment intervals that reduce the number of assessments required while shortening the waiting time to the next assessment for those most in need.

Indexed as

Cardiovascular DiseasesEpidemiologic MethodsPrimary PreventionPublic HealthRisk Assessment

Identifiers

PMID40166609
PMCPMC11956352

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.