Validity of cardiovascular risk prediction models in Latin America and among Hispanics in the United States of America: a systematic review

Abstract

. MeSH search terms and domains were related to CVD, prediction rules, Latin America (including the Caribbean), and Hispanics in the United States. Database searches were supplemented by correspondence with experts in the field. 1.68 (95% CI, incident myocardial infarction, 1.36 (95% CI, and CHD death, 1.21 (95% CI,. In Ecuador, a prediction model for CVD and total deaths in hypertensive patients had an area under the curve (AUC) of 0.79 (95% CI,, while the World Health Organization method had an AUC of 0.74 (95% CI,. A study predicting mortality risk in people with Chagas' disease had an AUC of 0.81 (95% CI, According to the World Health Organization (WHO), about 25% of all annual deaths in Latin America are due to cardiovascular diseases (CVD) (2, 3). Cardiovascular risk factors, including obesity, hypertension, hypercholesterolemia, diabetes mellitus, and tobacco use are highly prevalent in Latin America and contribute to three-fourths of its CVD cases (4). The prevalence of most, if not all, of these factors has been steadily increasing in recent years in Latin America, and the trend is expected to continue (3). Results. A total of 1 655 abstracts were identified, of which five cohorts with a total of 13 142 subjects met inclusion criteria. A Mexican cohort showed that the predicted/observed event-rate ratio for coronary heart disease (CHD) according to the Framingham risk score (FRS) wasData regarding CVD burden and trends among Hispanics living in the United States is also alarming and represents the most likely cause of death among this population (5), about 31% of all deaths (6). The prevalence of heart disease is 8.1% in Hispanics and 12.1% in Caucasians (7) and the prevalence of obesity (8), diabetes mellitus, hypertension, and dyslipidemia, is generally higher among Hispanics than Caucasians (7, 9).Estimation of CVD risk using prediction models is considered of high importance to public health since it can aid clinical decision-making, guide therapy, and make interventions more cost effective. It may also help direct public policy when measuring risk trends at the population level (10). In the last few decades, several cardiovascular risk prediction models have been created and introduced worldwide.The Framingham risk score (FRS) was the first of such tools and is arguably the most commonly used model for calculating 10-year risk for CVD events in the world. The FRS has been validated and recalibrated in several different populations, including Australia, China, Japan, New Zealand, Spain, and the United States (11)(12)(13)(14). These studies have shown that the FRS may overestimate CVD risk in some populations and under estimate it in others. Some other prediction models include the Prospective Cardiovascular Munster Heart Study (PROCAM) (15), the Reynolds score (16), and the Systematic Coronary Risk Evaluation system (SCORE) (17).The aim of this study was to assess the use and validity of CVD risk prediction models in Latin America and the Caribbean and among Hispanic populations in the United Sta...

Cardiovascular risk in middle-aged breast cancer survivors: a comparison between two risk models

“…Despite the elevated prevalence of risk factors, none of the participants was categorized using the SCORE model as being at highrisk of CVD, whereas 22% were found to be at highrisk according to the FRS model. FRS and SCORE models may overestimate or underestimate CVD risk in different scenarios 21,22 . A recent systematic review evaluating the use and validity of CVD risk prediction models in Latin America and the Caribbean and among Hispanic populations in the United States reported that FRS overestimates CVD risk among Hispanics when not adequately recalibrated 22 .…”

“…FRS and SCORE models may overestimate or underestimate CVD risk in different scenarios 21,22 . A recent systematic review evaluating the use and validity of CVD risk prediction models in Latin America and the Caribbean and among Hispanic populations in the United States reported that FRS overestimates CVD risk among Hispanics when not adequately recalibrated 22 . We found that the agreement between the two risk models was poor.…”

“…The SCORE system estimates the risk of fatal CVD 20 . The prognostic performance of CVD risk assessment models may vary according to the population studied 21,22 and the clinical condition of the patients 23,24 . Therefore, the aim of the present study was to investigate the prevalence of CVD risk factors, estimate cardiovascular risk according to the FRS and SCORE model, and evaluate the agreement between these two cardiovascular risk estimation models in middle-aged BCS.…”

Modelos predictivos de riesgo cardiovascular

“…La mayor prevalencia de DM se en-contró en Ciudad de México y Bogotá, donde se encuentran la hipertensión e hipercolesterolemia como unos de los factores que más infl uyen en el riesgo de padecer un evento cardiovascular mayor, aunque la combinación de hipertensión y DM demostró que la aumenta aún más. Un meta análisis (44) con 13142 personas demostró cómo el modelo de Framingham sobreestima el riesgo en Latinoamérica incluyendo el caribe y población hispana residente en Estados Unidos, este estudio además evidenció las pocas investigaciones referentes a validación aplicadas sobre esta población, solo 5 cumplían con una adecuada metodología aunque no se buscaron estudios no indexados, además de encontrar una amplia heterogeneidad entre la misma población probablemente debido a la dieta, estilos de vida e incluso genética y ascendencia todo lo cual limitaría el resultado de cada estudio a la población en la cual fue ajustada, si se quisiera aplicar esa escala ya calibrada para una población de Latinoamérica a otra en la cual no se haya realizada se deben hacer los ajustes correspondientes (2,44).…”

Análisis con perspectiva de género sobre percepción y prácticas en enfermedad coronaria en mujeres en el norte de México

“…[1][2][3] En los años noventa se reportó que los esfuerzos diagnósticos y terapéuticos en EC en mujeres eran menores que en hombres, por lo tanto la enfermedad era más letal en ellas. 4,5 Se han documentado diferencias biológicas entre ambos sexos, 6 desigualdades de géne-ro, baja presencia de mujeres en las investigaciones y subregistro de sus primeros síntomas coronarios. [7][8][9][10] La investigación inicial estudió las características biológicas y culturales de los hombres al verse principalmente afectados por la EC y estableció protocolos de manejo y programas de prevención.…”