Simultaneous derivation, validation, and comparison of predictor hazard ratios for cardiovascular risk prediction equations in patients with diabetes from high versus non-high income countries: cohort study
Authors' conclusion
Applying a high income country derived CVD risk prediction equation to a population from a non-high income country with diabetes may introduce systematic errors, primarily driven by differences in the effect of age.
Study context
- Population
- People aged 30–74 years with diabetes and no cardiovascular disease (CVD), electronic health records, New Zealand and China
- Participants
- 47,958 vs 46,558
- Exposure
- NZ-derived vs China-derived 5-year CVD risk equations in diabetes
- New Zealandn = 47,958reference
- Chinan = 46,558
- Outcome
- First CVD events; predictor HRs compared between country-specific equations; performance of NZ equations in the Chinese cohort before and after recalibration and updating
- Follow-up
- 5 years
Methodological detailsrisk prediction model derivation and validation
- Risk prediction model derivation and validation
Main finding
As reported in the abstract
First CVD events; age HR in sex-specific equations
| Group | Value | Age HR, women (per 10 years) |
|---|---|---|
| New Zealand | 11.7% | 1.61 (95% CI 1.51 to 1.71) |
New Zealand
Value11.7%
Age HR, women (per 10 years)1.61 (95% CI 1.51 to 1.71)
Observational data: associations, not effects.
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Simultaneous derivation, validation, and comparison of predictor hazard ratios for cardiovascular risk prediction equations in patients with diabetes from high versus non-high income countries: cohort study. BMJ. Published 11 September 2026. doi:10.
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