Abstract

Objective To assess the 10-year risk of a cardiovascular disease (CVD) event in a cohort of patients with diabetes, and to assess whether routine clinical practice can change this risk. Design A retrospective cohort study of 166 patients randomly selected from the database of a rural general hospital diabetes department. Method Using data on systolic blood pressure (SBP), total cholesterol and smoking status from 1995 and 1996, the 10-year risk of a CVD event was estimated for each patient using the Framingham Heart Study Coronary Heart Disease Risk Prediction Chart. The parameters were assessed to see whether any change was achieved by routine clinical practice. Results No significant changes in SBP, total cholesterol or smoking habit were achieved. The mean 10-year risk of a CVD event in 1995 and 1996 was 19.6 and 19.2% respectively (p=NS); 54% (1995) and 46% (1996) of patients had a 10-year risk of greater than 20%, approximately equating to an annual risk of 2%. Conclusion CVD risk in a cohort of patients with diabetes is alarmingly high, and routine clinical practice did not result in an overall reduction. CVD risk estimation charts can be used to identify patients at high risk of CVD, and more effective strategies are required to lower this risk.