| Title: | Long-term cardiovascular risks and statin treatment impact on socioeconomic inequalities: microsimulation model |
| Journal: | British Journal of General Practice |
| Published: | 27 Sep 2023 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/38373851/ |
| DOI: | https://doi.org/10.3399/bjgp.2023.0198 |
| URL: | https://bjgp.org/content/bjgp/early/2023/09/26/BJGP.2023.0198.full.pdf |
Publication 9466
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Abstract
BACKGROUND: UK cardiovascular disease (CVD) incidence and mortality have declined in recent decades but socioeconomic inequalities persist.</p>
AIM: To present a new CVD model, and project health outcomes and the impact of guideline-recommended statin treatment across quintiles of socioeconomic deprivation in the UK.</p>
DESIGN AND SETTING: A lifetime microsimulation model was developed using 117 896 participants in 16 statin trials, 501 854 UK Biobank (UKB) participants, and quality-of-life data from national health surveys.</p>
METHOD: A CVD microsimulation model was developed using risk equations for myocardial infarction, stroke, coronary revascularisation, cancer, and vascular and non-vascular death, estimated using trial data. The authors calibrated and further developed this model in the UKB cohort, including further characteristics and a diabetes risk equation, and validated the model in UKB and Whitehall II cohorts. The model was used to predict CVD incidence, life expectancy, quality-adjusted life years (QALYs), and the impact of UK guideline-recommended statin treatment across socioeconomic deprivation quintiles.</p>
RESULTS: Age, sex, socioeconomic deprivation, smoking, hypertension, diabetes, and cardiovascular events were key CVD risk determinants. Model-predicted event rates corresponded well to observed rates across participant categories. The model projected strong gradients in remaining life expectancy, with 4-5-year (5-8 QALYs) gaps between the least and most socioeconomically deprived quintiles. Guideline-recommended statin treatment was projected to increase QALYs, with larger gains in quintiles of higher deprivation.</p>
CONCLUSION: The study demonstrated the potential of guideline-recommended statin treatment to reduce socioeconomic inequalities. This CVD model is a novel resource for individualised long-term projections of health outcomes of CVD treatments.</p>
204 Authors
- Runguo Wu
- Claire Williams
- Junwen Zhou
- Iryna Schlackow
- Jonathan Emberson
- Christina Reith
- Anthony Keech
- John Robson
- Jane Armitage
- Alastair Gray
- John Simes
- Colin Baigent
- Borislava Mihaylova
- CTT Collaboration secretariat
- Jane Armitage
- Colin Baigent
- Elizabeth Barnes
- Lisa Blackwell
- Rory Collins
- Kelly Davies
- Jonathan Emberson
- Jordan Fulcher
- Heather Halls
- William G Herrington
- Lisa Holland
- Anthony Keech
- Adrienne Kirby
- Borislava Mihaylova
- Rachel O'Connell
- David Preiss
- Christina Reith
- John Simes
- Kate Wilson
- CTT Collaboration trialists: A to Z trial
- Michael Blazing
- Eugene Braunwald
- James de Lemos
- Sabina Murphy
- Terje R Pedersen
- Marc Pfeffer
- Harvey White
- Stephen Wiviott
- AFCAPS/TEXCAPS
- Michael Clearfield
- John R Downs
- Antonio Gotto
- Stephen Weis
- ALERT
- Bengt Fellström
- Hallvard Holdaas
- Alan Jardine
- Terje R Pedersen
- ALLHAT
- David Gordon
- Barry Davis
- Curt Furberg
- Richard Grimm
- Sara Pressel
- Jeffrey L Probstfield
- Mahboob Rahman
- Lara Simpson
- ALLIANCE
- Michael Koren
- ASCOT
- Björn Dahlöf
- Ajay Gupta
- Neil Poulter
- Peter Sever
- Hans Wedel
- ASPEN
- Robert H Knopp
- AURORA
- Stuart Cobbe
- Bengt Fellström
- Hallvard Holdaas
- Alan Jardine
- Roland Schmieder
- Faiez Zannad
- CARDS
- D John Betteridge
- Helen M Colhoun
- Paul N Durrington
- John Fuller
- Graham A Hitman
- Andrew Neil
- CARE
- Eugene Braunwald
- Barry Davis
- C Morton Hawkins
- Lemuel Moyé
- Marc Pfeffer
- Frank Sacks
- CORONA
- John Kjekshus
- Hans Wedel
- John Wikstrand
- 4D
- Christoph Wanner
- Vera Krane
- GISSI Heart Failure and Prevention trials
- Maria Grazia Franzosi
- Roberto Latini
- Donata Lucci
- Aldo Maggioni
- Roberto Marchioli
- Enrico B Nicolis
- Luigi Tavazzi
- Gianni Tognoni
- HOPE-3
- Jackie Bosch
- Eva Lonn
- Salim Yusuf
- HPS
- Jane Armitage
- Louise Bowman
- Rory Collins
- Anthony Keech
- Martin Landray
- Sarah Parish
- Richard Peto
- Peter Sleight
- IDEAL
- John JP Kastelein
- Terje R Pedersen
- JUPITER
- Robert Glynn
- Antonio Gotto
- John JP Kastelein
- Wolfgang Koenig
- Jean MacFadyen
- Paul M Ridker
- LIPID
- Anthony Keech
- Stephen MacMahon
- Ian Marschner
- Andrew Tonkin
- John Shaw
- John Simes
- Harvey White
- LIPS
- Patrick W Serruys
- Post-CABG
- Genell Knatterud
- PROSPER
- Gerard J Blauw
- Stuart Cobbe
- Ian Ford
- Peter Macfarlane
- Chris Packard
- Naveed Sattar
- James Shepherd
- Stella Trompet
- PROVE-IT
- Eugene Braunwald
- Christopher P Cannon
- Sabina Murphy
- SEARCH
- Rory Collins
- Jane Armitage
- Louise Bowman
- Richard Bulbulia
- Richard Haynes
- Sarah Parish
- Richard Peto
- Peter Sleight
- SPARCL
- Pierre Amarenco
- K Michael Welch
- 4S
- John Kjekshus
- Terje R Pedersen
- Lars Wilhelmsen
- TNT
- Philip Barter
- Antonio Gotto
- John LaRosa
- John JP Kastelein
- James Shepherd
- WOSCOPS
- Stuart Cobbe
- Ian Ford
- Sharon Kean
- Peter Macfarlane
- Chris Packard
- Michele Roberston
- Naveed Sattar
- James Shepherd
- Robin Young
- Other CTT Collaboration members
- Hiroyuki Arashi
- Robert Clarke
- Marcus Flather
- Shinya Goto
- Uri Goldbourt
- Jemma Hopewell
- G Kees Hovingh
- George Kitas
- Connie Newman
- Marc S Sabatine
- Gregory G Schwartz
- Liam Smeeth
- Jonathan Tobert
- John Varigos
- Junichi Yamamguchi
1 Application
| Application ID | Title |
|---|---|
| 56757 | Developing chronic disease models to inform health policy and guide treatment decisions |
Enabling scientific discoveries that improve human health