What are the key epidemiological factors to consider when assessing the risk of cardiovascular disease in my patient population?

When assessing the risk of cardiovascular disease (CVD) in your patient population, key epidemiological factors to consider include age, sex, ethnicity, socioeconomic status, and the presence of specific clinical conditions and lifestyle factors. Age is a major determinant, with people aged 85 or older considered at increased risk due to age alone, especially if they smoke or have raised blood pressure ¹. Sex differences influence risk profiles, with men generally at higher risk earlier in life, but risk in women increases post-menopause (Goldsborough E 3rd et al., 2023). Ethnicity is important as certain groups, such as Black and South Asian populations, have higher CVD risk, necessitating culturally sensitive risk assessment and interventions ¹,³. Socioeconomic factors and deprivation are critical epidemiological determinants, as disadvantaged populations often have higher prevalence of risk factors like smoking, poor diet, and limited access to healthcare services ²,³.

Clinical factors include established comorbidities such as type 2 diabetes, chronic kidney disease, familial hypercholesterolaemia, and autoimmune or systemic inflammatory disorders, which elevate CVD risk and may require tailored assessment tools like QRISK3 rather than QRISK2 ¹[(Wong and Sattar, 2023)]. Lifestyle factors such as smoking status, physical inactivity, alcohol consumption, and obesity are also pivotal epidemiological contributors to CVD risk ¹,². Additionally, medication use that affects lipid metabolism or inflammation (e.g., corticosteroids, immunosuppressants, atypical antipsychotics) should be considered as they may increase risk but are not always captured by standard risk tools ¹.

It is essential to use a systematic approach to identify individuals at high risk, prioritising those with an estimated 10-year CVD risk of 10% or more using validated tools like QRISK3, which incorporates many of these epidemiological factors including ethnicity, comorbidities, and medication use ¹. For younger patients or those with lower short-term risk but significant risk factors, lifetime risk tools such as QRISK3-lifetime can help inform discussions and motivate lifestyle changes ¹. Furthermore, understanding local population prevalence, incidence, and social determinants of health is crucial for tailoring prevention programmes and addressing health inequalities effectively ²,³.