Development and 10-year validation of QRISK4-Lifetime for cardiovascular risk prediction in 13 million adults

QRISK4-Lifetime predicts cardiovascular disease to age 95 with 10-year discrimination matching QRISK4 in 13 million adults, with C-indices of 0.860 in women and 0.845 in men.

• Why it matters: Clinicians need risk estimates that extend beyond 10 years to support prevention discussions, but the long-term validity and how classifications differ across time horizons remain unclear.
• What they did: Using linked English electronic health records and sex-specific cause-specific Cox models, the study fitted QRISK4-Lifetime and evaluated 10-year discrimination and calibration overall, by age and ethnicity, in derivation and validation cohorts.
• The result: In the 10-year assessment, observed risks were close to predicted, and both approaches selected 310,648 patients (9.6%); 262,417 (8.1%) met only the lifetime threshold, with 72.8% under 40 years and 79.5% men.

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