A simple computer program for guiding management of cardiovascular risk factors and prescribing

Objective To describe, and to test against trial data, a simple and flexibl e computer program for calculating cardiovascular risk in individual patien ts as an aid to managing risk factors and prescribing drugs to lower choles terol concentration and blood pressure. Design Descriptive comparison of actual cardiovascular risk in randomised c ontrolled trials of cholesterol reduction with risk predicted by a computer program based on the Framingham risk equation. Comparison of the program's performance with that of tables and guidelines by means of hypothetical ca se examples. Main outcome measures Average risk of coronary heart disease and myocardial infarction. Results The computer program accurately predicted baseline absolute risk in a UK population as well as the relative and absolute reduction in risk fro m cholesterol lowering for primary prevention of coronary heart disease. Th e program also allowed a more refined estimate of absolute risk of coronary heart disease than some existing tables and enabled the impact of prescrib ing decisions to be quantified and costed. Conclusions This simple computer program to estimate individuals' cardiovas cular disease risk and display the benefits of intervention should help cli nicians and patients decide on the most effective packages of risk reductio n and identify those most likely to benefit from modulation of risk factors .