Risk assessment in the prevention of cardiovascular disease in low-resource settings

Ofori, Sandra N.; Odia, O J

doi:10.1016/j.ihj.2015.07.004

Cited by 41 publications

(38 citation statements)

References 52 publications

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“…These results are similar to the present study, indicate that the use of the WHO chart for risk assessment is not advisable in all developing countries without their own score. 22 However, some studies recommended the use of WHO's charts in low-income countries, 11,[23][24][25] this recommendation is not consistent with our finding. Although all risk assessment tools do the same method, different tools, for one person, perform different categories.…”

Section: Discussioncontrasting

confidence: 87%

“…10 In countries with low resources, which do not have national cohort studies, WHO recommended a tool with two charts (Laboratory and non-laboratory) for prediction and prevention of CVDs. 11 A comparison of different risk management tools can show the degree of agreement of tools in diverse populations. This is an incentive to persuade national health funding organizations to support longitudinal studies in order to design specific CVD prevention tools fine-tuned for their population.…”

Section: Introductionmentioning

confidence: 99%

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Agreement between Framingham, IraPEN and non-laboratory WHO-EMR risk score calculators for cardiovascular risk prediction in a large Iranian population

Mehrara

Mirzaei

2019

J Cardiovasc Thorac Res

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Introduction: Estimation of the risk of cardiovascular diseases (CVD), may lead to prophylactic therapies. This study aims to compare and evaluate the agreement between CVD prediction of Iran Package of Essential Non-communicable Disease (IraPEN) and Framingham risk score (FRS).<br /> Methods: All 40-79 years old participants in the Yazd Health Study who did not have a history of CVD were included. The 10-years risk of CVD was estimated by the laboratory (IraPEN), non-laboratory WHO-EMR B and FRS. The risk was classified into low, moderate and high-risk groups. Cohen’s weighted kappa statistics were used to assess agreement between tools. To assess discrepancies McNemar’s χ2 test for paired data was used. P values < 0.05 were considered statistically significant.<br /> Results: In total, 2103 participant was included and the risk scores were calculated. Of them, 26.5% were stratified as high risk by FRS, compared with 6.1% by IraPEN. A slight agreement (37.9%) was observed (kappa 0.17, P < 0.0001), in other words. This discrepancy between IraPEN vs. FRS was seen in both sexes (P < 0.0001), although in women the agreement ratio was higher (52.1% vs. 21.3%). The discrepancy between FRS and IraPEN in categorizing people at risk of CVD was 55.5%, (P < 0.0001) but this was not significant between IraPEN and non-laboratory WHO-EMR-B (World Health Organization - Eastern Mediterranean Regional-B group countries) score (P < 0.523; discrepancies, 5.8%).<br /> Conclusion: Our study shows a slight agreement between various CVD risk scores. Thus, reviewing the IraPEN and using alternative tools for the low-risk group should be considered by decision-makers. It is important to use a more reliable score for nation-wide risk assessment.

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Section: Discussioncontrasting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Agreement between Framingham, IraPEN and non-laboratory WHO-EMR risk score calculators for cardiovascular risk prediction in a large Iranian population

Mehrara

Mirzaei

2019

J Cardiovasc Thorac Res

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“…In low/middle-income countries there is a scarcity of national guidelines on CVD risk assessment compared with developed nations 31. Thus, in order to prevent CVD in an appropriate and cost-effective manner in low-resource settings, the total CVD risk calculation instead of screening for and treating single risk factors approach has been proven to lead to better CVD prevention and clinical outcomes 32.…”

Section: Discussionmentioning

confidence: 99%

Gender differences in cardiovascular risk assessment in elderly adults in Ecuador: Evidence from a national survey

Sisa

2019

Journal of Investigative Medicine

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The present study aimed to predict the risk of developing cardiovascular disease (CVD) over a 5-year period and how it might vary by sex in an ethnically diverse population of older adults. We used a novel CVD risk model built and validated in older adults named the Systematic Coronary Risk Evaluation in Older Persons (SCORE OP). A population-based study analyzed a total of 1307 older adults. Analyses were done by various risk categories and sex. Of the study population, 54% were female with a mean age of 75±7.1 years. According to the SCORE OP model, individuals were classified as having low (9.8%), moderate (48.1%), and high or very high risk (42.1%) of CVD-related mortality. Individuals at higher risk of CVD were more likely to be male compared with females, 53.9% vs 31.8%, respectively (p<0.01). Males were more likely to be younger, living in rural areas, had higher levels of schooling, and with the exception of smoking status and serum triglycerides, had lower values of traditional risk factors than females. In addition, males were less likely to require blood pressure-lowering therapy and statin drugs than females. This gender inequality could be driven by sociocultural determinants and a risk factor paradox in which lower levels of the cardiovascular risk factors are associated with an increase rather than a reduction in mortality. These data can be used to tailor primary prevention strategies such as lifestyle counseling and therapeutic measures in order to improve male elderly health, especially in low-resource settings.

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“…The risk level for cardiovascular disease was determined by the Framingham risk score method. The risk factors that were measured included age, cholesterol level, high-density lipoprotein (HDL) level, systolic blood pressure, treatment of hypertension, and smoking habits [6]. The measurements for men and women were calculated separately.…”

Section: Methodsmentioning

confidence: 99%

Health Risk Assessment for Prevention of Cardiovascular Disease in Workers at PT. X

Hamro¹,

Modjo²

2018

KLS

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Risk assessment in the prevention of cardiovascular disease in low-resource settings

Abstract: In low-resource settings, the consistent use of simple tools like the WHO charts is recommended, as the benefit of a standard approach to screening outweighs the risk of missing an opportunity to prevent CVD.

Cited by 41 publications

References 52 publications

Agreement between Framingham, IraPEN and non-laboratory WHO-EMR risk score calculators for cardiovascular risk prediction in a large Iranian population

Agreement between Framingham, IraPEN and non-laboratory WHO-EMR risk score calculators for cardiovascular risk prediction in a large Iranian population

Gender differences in cardiovascular risk assessment in elderly adults in Ecuador: Evidence from a national survey

Health Risk Assessment for Prevention of Cardiovascular Disease in Workers at PT. X

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