Not For Use - Cardiovascular disease (atherosclerotic, broad, primary care)

IMPORTANT: A potential issue has been identified with this phenotype and it should not be used pending further investigations and correction

This phenotype is intended to capture a broad definition of atherosclerotic cardiovascular disease as recorded in primary care records, including ischaemic heart disease, cerebrovascular disease, peripheral vascular disease and abdominal aortic aneurysm.

In some cases, frequently-used codes (such as codes for stroke that do not specify subtype) do not give enough information to distinguish between diseases likely to be caused by atherosclerotic vs non-atherosclerotic pathology. Pragmatic inclusion choices were made where clinical advice was that the code would predominantly capture atherosclerotic disease.

This is a primary-care-data only phenotype designed for analysis of recorded prevalent disease in the general practice population. Additional cases may be identified using other data sources, including secondary care data or death records.

This phenotype was developed using existing code lists, including Cardiovascular disease (PH894, 1867), Peripheral arterial disease (PH236, 472) and Abdominal Aortic Aneurysm (PH1023, 2255). Codes relating to haemorrhagic subtypes of cerebrovascular disease and some cardiac dysrhythmias were dropped. Additional codes relating to additional atherosclerotic conditions were added.

Codes have been standardised to 5 character format (not including the possible additional 2 characters of the term code, but with padding to 5 digits using “.” where stems appear). Please note that codes including “.” may be corrupted if opened using software that attempts to coerce them to numeric (such as Excel).

Any appearance of these codes can be identified in Read-coded primary care data (such as WLGP) to identify the phenotype. Note that this is a primary-care-data only phenotype designed for analysis of recorded prevalent disease in the general practice population. It therefore relies on cases being recorded in primary care data. Additional cases may be identified using other sources, including secondary care data or death records. Notably, a primary-care-only phenotype may not be appropriate in analyses of incident disease as it would be less likely to identify fatal cases.