Cardiovascular disease (conditions affecting the heart or blood vessels) accounts for around 1 in 4 deaths in the UK each year, according to the British Heart Foundation, with healthcare costs in England estimated at £10 billion a year.
A person’s risk of cardiovascular disease depends on their blood pressure, weight, cholesterol, smoking status, family history, and other factors. Identifying someone at increased risk allows them to take preventive measures, for example, changing their lifestyle or taking medicines. Such measures can reduce risk and improve health outcomes, and potentially delay or prevent cardiovascular disease.
Predicting and preventing ill health is a priority in the Government’s 10 year plan for the NHS in England. An assessment of cardiovascular risk is part of routine care during the NHS Health Check, but research suggests that the identification of individuals’ future risk could be improved.
In July 2025, an NIHR Evidence webinar highlighted 3 promising NIHR projects, based on information from clinical care. The research points to new ways to identify people at risk of heart and circulation problems.
New QRISK4 tool predicts 10 year cardiovascular risk
Cardiovascular risk calculators, such as QRISK3, are tools used by clinicians to estimate people’s risk of having or developing a heart condition over time. They use routinely collected information such as age, sex, and blood pressure. QRISK3 is recommended by the National Institute for Health and Care Excellence (NICE) as part of formal assessments of cardiovascular disease risk for people aged between 25 and 84.
Julia Hippisley-Cox, Professor of Clinical Epidemiology and Predictive Medicine, Queen Mary University of London and Honorary Consultant in Public Health, Barts NHS Trust, delivered the first presentation at the webinar. She discussed the latest version of her team’s cardiovascular risk calculator: QRISK4. The findings were published in Nature Medicine.
Development and validation of a new algorithm for improved cardiovascular risk prediction; Julia Hippisley-Cox, Carol A. C. Coupland, Mona Bafadhel, Richard E. K. Russell, Aziz Sheikh, Peter Brindle & Keith M. Channon. Nat Med 30, 1440–1447 (2024). https://doi.org/10.1038/s41591-024-02905-y. Funding: NIHR, John Fell Fund, Oxford. Data: QResearch database & NHS England & GP practices
AI-enabled ECG for cardiovascular disease risk prediction
An ECG (electrocardiogram) records the electrical activity of the heart. It is used to diagnose cardiovascular problems and predict people’s risk of future problems. Recently, researchers have developed AI (artificial intelligence) tools that improve diagnosis and risk detection from ECGs.
Fu Siong Ng, Reader in Cardiac Electrophysiology, Imperial College London, and Consultant Cardiologist, Imperial College Healthcare NHS Trust and Chelsea and Westminster Hospital NHS Foundation Trust, delivered the second presentation. He discussed an AI-enabled ECG that his team developed. Their main findings were published in The Lancet Digital Health.
Personalised cardiovascular risk prediction with cardiac CT
People with sustained chest pain may be referred for a CT scan (computed tomography) of the heart. The scan may reveal a build-up of plaque on the walls of arteries, which narrows them and can lead to heart problems; it can be treated with surgery. However, for someone who does not have narrowed arteries, management is less clear and they may be discharged. Many of these people go on to develop heart problems.
Standard heart scans do not detect inflammation of the arteries, which is another cause of heart problems. Now, researchers have developed a method of assessing inflammation of the arteries in CT scans by analysing fat tissue.
Kenneth Chan, Clinical Research Fellow in Cardiology, University of Oxford, gave the third presentation. He described the tool developed by his team. It uses AI to predict the risk of heart problems among people with sustained chest pain but without narrowed arteries. The tool combines information from CT scans (such as the level of inflammation in the arteries and plaque build-up) with routinely collected data (on age, sex, and health conditions, for instance). The findings were published in The Lancet.
How to cite: NIHR Evidence; Cardiovascular disease: new ways to detect risk and improve outcomes; July 2025; doi: 10.3310/nihrevidence_66159
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