QRISK3: Comprehensive Explanation and Clinical Context
The QRISK3 score is a predictive algorithm designed to estimate the 10-year risk of developing a cardiovascular event (such as myocardial infarction or stroke).
It represents the third-generation update of the QRISK series developed in the United Kingdom by Hippisley-Cox and Coupland.
QRISK3 integrates both classical and novel risk factors including age, sex, systolic blood pressure, lipid profile, smoking, diabetes, and comorbidities such as rheumatoid arthritis, lupus, chronic kidney disease, or severe mental illness.
Normal Value: There is no “normal” QRISK3 value; however, a 10-year risk <10% is considered low, 10-20% moderate, and >20% high.
Clinical Significance: QRISK3 is used to guide preventive therapy in primary care.
Patients with a QRISK3 score >10% are typically recommended to start statin therapy, adopt intensive lifestyle modifications, and undergo periodic risk reassessment.
Clinical Interpretation Summary:
QRISK3 improves upon previous versions by incorporating non-traditional predictors and has better calibration in modern, multimorbid populations.
Its simplicity and integration into electronic medical records make it a practical and evidence-based approach for cardiovascular prevention.
References:
1. Hippisley-Cox J, Coupland C. Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: prospective cohort study. BMJ. 2017;357:j2099.
2. National Institute for Health and Care Excellence (NICE). Cardiovascular disease: risk assessment and reduction, including lipid modification (CG181), updated 2023.
3. QRISK3 Official Calculator: https://qrisk.org/three/