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The Authors' reply: We thank Professor Hippisley-Cox and colleagues1 for their comments on our paper.2 We agree that our study has limitations, but consider that we have stated these clearly within the manuscript. We believe that, notwithstanding these limitations, we bring new information regarding the performance of these widely used cardiovascular risk scores in three British ethnic groups. Importantly, these analyses were conducted independently of the authors of QRISK2 and Framingham risk scores and we report ethnicity-specific findings. Our take-home messages are that these risk scores performed differently and only modestly in the SABRE cohort in identifying individuals at high risk who would later go on to suffer events (particularly in South Asian women and in African Caribbean men and women). We suggest that further independent validation in other multiethnic data sets would be helpful.
With regard to specific comments, our responses are below:
We agree that numbers of events were few in women, and indeed in African Caribbeans of both sexes—for this reason we urged caution in interpretation of the findings in these groups under ‘strengths and …