Comparison of cardiovascular risk calculation tools in pharmacy practice

Objective: To examine the use of various cardiovascular disease (CVD) risk estimation calculators in pharmacy practice. Design: Longitudinal cohort study. Setting: Midwestern university worksite from August 2008 through May 2012. Participants: University employees with hypertension, dyslipidemia, and diabetes. Intervention: Risk estimation calculators were applied to data from a pharmacist-run chronic disease management program. Main outcome measure: Difference in estimated CVD risk from multiple estimation calculators. Results: At baseline and 12 months, non-lab-based tools reported significantly higher 10-year CVD risk percentages compared with lab-based tools among the same cohort of patients (10.63% vs. 8.71% at baseline, P < 0.001; 9.34% vs. 7.31% at 12 months, P < 0.001). In addition, the electronic version of 10-year CVD risk reported significantly higher values than the paper version when applied to the same patient cohort (7.31% vs. 6.60% at 12 months, P = 0.018). Conclusion: CVD risk estimation tools report significantly different values and are not interchangeable. Pharmacists using non-lab-based tools should expect significantly higher risk estimates than estimates derived from lab-based tools and therefore should use the same version of the estimation tool over the long term.