Article ; Online: Long-term cardiovascular risks and the impact of statin treatment on socioeconomic inequalities: a microsimulation model.
The British journal of general practice : the journal of the Royal College of General Practitioners
2024
Abstract: Background: UK cardiovascular disease (CVD) incidence and mortality have declined in recent decades but socioeconomic inequalities persist.: Aim: To present a new CVD model, and project health outcomes and the impact of guideline-recommended statin ... ...
| Abstract | Background: UK cardiovascular disease (CVD) incidence and mortality have declined in recent decades but socioeconomic inequalities persist. 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. 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. 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. 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. 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. |
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| Language | English | ||||||||||
| Publishing date | 2024-02-19 | ||||||||||
| Publishing country | England | ||||||||||
| Document type | Journal Article | ||||||||||
| ZDB-ID | 1043148-2 | ||||||||||
| ISSN | 1478-5242 ; 0035-8797 ; 0960-1643 | ||||||||||
| ISSN (online) | 1478-5242 | ||||||||||
| ISSN | 0035-8797 ; 0960-1643 | ||||||||||
| DOI | 10.3399/BJGP.2023.0198 | ||||||||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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