Heart Risk Calculators May Give Wrong Results for People with Diabetes Outside Wealthy Nations, Study Finds

A BMJ study warns that standard heart disease risk tools, built on data from high-income countries, can produce systematic errors when used on patients with diabetes living elsewhere.

Doctors calculating the risk of heart disease in patients with diabetes may be getting skewed results if they rely on equations designed for wealthier nations, according to new research published in the BMJ. The study found that applying these tools to populations in lower-income countries introduces systematic errors — and that the main driver is how the effect of age is calculated differently across those populations.

Cardiovascular disease (CVD) risk prediction equations are used by clinicians to estimate how likely a patient is to have a heart attack or stroke. Getting that calculation wrong can mean patients either miss out on preventive treatment or receive it unnecessarily.

The BMJ’s findings point to a specific technical flaw: the relationship between age and CVD risk does not behave the same way in non-high-income country populations as it does in the datasets these tools were built from. So a tool that works well in, say, the UK or the United States may quietly overestimate or underestimate risk for a 55-year-old patient with diabetes in a lower-income setting.

This matters for Kent residents too — not because the county sits outside a wealthy nation, but because NHS clinicians here treat patients from various ethnic and national backgrounds, some of whom may have been assessed using tools not validated for their population.

If you have diabetes and are concerned about your heart health, speak to your GP or diabetes care team. They can discuss which risk assessment tools are being used in your care. For general health queries, NHS 111 is available by phone or online around the clock.