World Health Organization (WHO) and International Society of Hypertension (ISH) risk prediction charts: assessment of cardiovascular risk for prevention and control of cardiovascular disease in low and middle-income countries

Abstract

Cardiovascular disease (CVD) is the leading cause of the growing global disease burden due to non-communicable diseases. For successful prevention and control of CVD, strategies that focus on individuals need to complement population-wide strategies. Strategies that focus on individuals are cost effective only when targeted at high-risk groups. Risk prediction tools that easily and accurately predict an individual's absolute risk of CVD are key to targeting limited resources at high-risk individuals who are likely to benefit the most. Health systems in low-income countries do not have the basic infrastructure facilities to support resource-intensive risk prediction tools, particularly in primary healthcare. The WHO/ISH charts presented here, enable the prediction of future risk of heart attacks and strokes in people living in low and middle income countries, for the first time. Furthermore, since the charts use simple variables they can be applied even in low resource settings. Thus the WHO/ISH risk predication charts and the accompanying guideline will improve the effectiveness of cardiovascular risk management even in settings which do not have sophisticated technology.

Development and validation of a cardiovascular risk prediction model for Japanese: the Hisayama study

“…Large-scale cohort studies have developed a number of risk prediction tools of cardiovascular disease. [4][5][6][7][8][9][10][11][12][13][14][15] However, these risk prediction tools were mainly derived from studies carried out in Western populations and few risk prediction tools are developed among general Japanese populations. The NIPPON DATA 80 derived a cardiovascular risk prediction tool, in which age, sex, systolic blood pressure, glucose levels, total cholesterol and smoking habits were included as risk factors, using data obtained from a 19-year prospective cohort study of general Japanese populations, although the outcome of NIPPON DATA 80 risk charts was death from cardiovascular causes.…”

“…3 To identify individuals at high risk of cardiovascular disease, a number of risk prediction tools have been developed. [4][5][6][7][8][9][10][11][12][13][14][15] However, currently available risk prediction tools of cardiovascular disease are derived mainly from studies carried out in Western populations and few risk prediction tools are developed for general Japanese populations. The objective of this paper is to develop a new cardiovascular risk prediction model and to validate its performance in a general population of Japanese.…”

Occupational stress and cardiovascular disease

“…Elevated blood pressure (BP), particularly if it is chronic (hypertension), poses an established risk for CVD (Mendis, et al, 2007). Possible associations between OS and BP have therefore been targeted to elucidate the link between OS and CVD.…”

The metabolic syndrome: useful concept or clinical tool? Report of a WHO Expert Consultation

“…Although metabolic syndrome can predict diabetes and CVD, the construct was never intended for use as a detailed risk predictor, and there are other tools available which provide a measure of absolute risk within defined populations. In resource-poor settings, the use of WHO risk charts could be useful to inform risk stratification [30]. More developed health settings can adopt a pragmatic stepwise approach to risk stratification, where routine data or simple questionnaires are used to identify those at increased risk (without the need for laboratory measures).…”