scholarly journals Predicting 10-year cardiovascular risk using WHO/ISH risk prediction chart among urban population in Salem

2018 ◽  
Vol 5 (12) ◽  
pp. 5228
Author(s):  
K. Premanandh ◽  
R. Shankar
Keyword(s):  
Cardiovascular Risk ◽  
High Risk ◽  
Risk Prediction ◽  
Disease Risk ◽  
Smoking Status ◽  
Cardiovascular Disease Risk ◽  
Total Serum ◽  
Total Serum Cholesterol ◽  
Cvd Risk ◽  
Very High

Background: Coronary vascular disease (CVD) risk estimation tools are a simple means of identifying those at high risk in a community and hence a potentially cost-effective strategy for CVD prevention in resource-poor countries. The WHO /ISH risk prediction charts provide approximate estimates of cardiovascular disease risk in people who do not have established coronary heart disease, stroke or other atherosclerotic disease.Methods: A total of 280 subjects between 40 to 70 years of age were included in this cross sectional study. Eligible households was selected randomly (every 5th household) for the interview using systematic random sampling. Age, gender, smoking status, systolic blood pressure, presence or absence of diabetes and total serum cholesterol were used to compute the total CVD risk using WHO/ISH CVD risk prediction chart. The chart stratify an individual into low (<10%), moderate (10% to <20%), high (20% to <30%), and very high (>30%) risk groups.Results: Moderate and high CVD risk were 12.14% and 7.5% respectively. Of total study participants, 2.5% had very high risk (>40%). High risk (binge drinking) alcohol drinkers (p=0.04) and abdominal obesity (p=0.0001) were significantly associated with higher CVD risk. Higher prevalence of behavioral risk factors was also reported in our study population.Conclusions: A large proportion of the population is at moderate and high cardiovascular risk. Risk stratification and identification of individuals with a high risk for CHD who could potentially benefit from intensive primary prevention efforts are critically important in reducing the burden of CVD in India.

scholarly journals Assessment of Cardiovascular Disease Risk among Qatari Patients with Type 2 Diabetes Mellitus, Attending Primary Health Care Centers, 2014

2020 ◽  
Vol 10 (1) ◽  
pp. 1-10
Author(s):  
Anees Al-yafei ◽  
Sherif O. Osman ◽  
Nagah Selim ◽  
Noora Alkubaisi ◽  
Rajvir Singh
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Risk Prediction ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Diabetic Patients ◽  
Total Risk ◽  
Framingham Score ◽  
Very High

Background: The accumulated knowledge on the development of cardiovascular disease in diabetic patients due to clustering and synergistic interaction of multiple risk factors leads to the establishment of cardiovascular disease 10-year risk prediction tools. The management of patients based on their total risk prediction is an effective way to reduce disease burden. The behavior of such tools varies based on population and their risk profile. Objective: To estimate the total 10-year cardiovascular disease risk using General Framingham Risk Prediction Score and World Health Organization /International Society for Hypertension (WHO/ISH) Risk Prediction Chart on Qatari diabetic patients. Methods: Cross-sectional design was used. A total of 532 Qatari diabetic patients attending primary healthcare were enrolled. Data were collected using an interview administered questionnaire, anthropometric & blood pressure measurement, and medical records. The total 10-year cardiovascular disease risk was assessed using the WHO/ISH risk prediction chart and Framingham score. Results: The former categorized (81.6%) of participants as low risk and only (3.8%) as in high and very high risk. While the later categorized (12.2%) of participants as low risk and (57.6%) as in high and very high risk. No agreement between both tools in assessment of cardiovascular disease risk (κ = - 0.019, p-value = 0.216). All risk factors used by both tools illustrated a statistically significant relation with risk categories, except ‘anti-hypertensive medications intake’ in the Framingham score. Conclusion: Encouraging assessment of patients based on total risk rather than single risk factor and further study of total risk prediction can help to establish a national tool for Qatar.

scholarly journals Evaluation of cardiovascular risk in adults with type 1 diabetes: poor concordance between the 2019 ESC risk classification and 10-year cardiovascular risk prediction according to the Steno Type 1 Risk Engine

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Nicola Tecce ◽  
Maria Masulli ◽  
Roberta Lupoli ◽  
Giuseppe Della Pepa ◽  
Lutgarda Bozzetto ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Risk Prediction ◽  
Risk Classification ◽  
Preventive Strategy ◽  
Cvd Risk ◽  
Risk Engine ◽  
Very High

Abstract Background Patients with type 1 diabetes (T1D) have higher mortality risk compared to the general population; this is largely due to increased rates of cardiovascular disease (CVD). As accurate CVD risk stratification is essential for an appropriate preventive strategy, we aimed to evaluate the concordance between 2019 European Society of Cardiology (ESC) CVD risk classification and the 10-year CVD risk prediction according to the Steno Type 1 Risk Engine (ST1RE) in adults with T1D. Methods A cohort of 575 adults with T1D (272F/303M, mean age 36 ± 12 years) were studied. Patients were stratified in different CVD risk categories according to ESC criteria and the 10-year CVD risk prediction was estimated with ST1RE within each category. Results Men had higher BMI, WC, SBP than women, while no difference was found in HbA1c levels between genders. According to the ESC classification, 92.5% of patients aged < 35 years and 100% of patients ≥ 35 years were at very high/high risk. Conversely, using ST1RE to predict the 10-year CVD risk within each ESC category, among patients at very high risk according to ESC, almost all (99%) had a moderate CVD risk according to ST1RE if age < 35 years; among patients aged ≥35 years, the majority (59.1%) was at moderate risk and only 12% had a predicted very high risk by ST1RE. The presence of target organ damage or three o more CV risk factors, or early onset T1D of long duration (> 20 years) alone identified few patients (< 30%) among those aged ≥35 years, who were at very high risk according to ESC, in whom this condition was confirmed by ST1RE; conversely, the coexistence of two or more of these criteria identified about half of the patients at high/very high risk also according to this predicting algorithm. When only patients aged ≥ 50 years were considered, there was greater concordance between ESC classification and ST1RE prediction, since as many as 78% of those at high/very high risk according to ESC were confirmed as such also by ST1RE. Conclusions Using ESC criteria, a large proportion (45%) of T1D patients without CVD are classified at very high CVD risk; however, among them, none of those < 35 years and only 12% of those ≥ 35 years could be confirmed at very high CVD risk by the ST1RE predicting algorithm. More studies are needed to characterize the clinical and metabolic features of T1D patients that identify those at very high CVD risk, in whom a very aggressive cardioprotective treatment would be justified.

Abstract P133: Modeling Smoking in Relation to Cardiovascular Disease Risk in the Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Robin M Nance ◽  
Joseph A Delaney ◽  
Michael Blaha ◽  
Gregory Burke ◽  
Joel D Kaufman ◽  
...  
Keyword(s):  
Heart Disease ◽  
Disease Risk ◽  
Smoking Status ◽  
Cardiovascular Disease Risk ◽  
Additive Models ◽  
Limiting Current ◽  
Cvd Risk ◽  
Intensity Effect ◽  
Current Smoking ◽  
Smoking Exposure

Objectives: Smoking exposure can be measured in a variety of ways including duration, intensity (cigarettes /day), and the product of these known as pack-years. How these variables should be combined to best model smoking as an exposure in cardiovascular (CVD) studies is not clear. Methods: The MESA study is a cohort of 6814 participants initially free of clinical heart disease at baseline in 2000-2002. MESA collected questionnaire data on smoking duration, intensity, and pack-years. Initial models were stratified by current versus former smoking status, with a second set of models that pooled all participants and controlled for status. Generalized additive models for time to incident CVD (myocardial infarction, stroke, and CVD death) were used to investigate the functional form of each aspect of smoking. Cox models were used to investigate the hazard ratio (HR) of each exposure definition of smoking on time to event. Models were compared which used intensity and duration alone, in combination, and expressed as pack-years. The interaction between duration and intensity was also tested. All models were adjusted for age, sex, and race/ethnicity. We summarized model performance using the pseudo- R 2 statistic and the area under the receiver-operator characteristic curve (AUC). Results: There were 2487 former and 887 current smokers at baseline, with 370 incident CVD events over a median of 8.5 years. There was no significant non-linearity detected for intensity, duration or pack-years with respect to CVD risk. Among the former smokers none of duration, intensity, and pack-years was significant. Among the current smokers, only intensity was significant (HR for cigarettes/day 1.03, p=0.005). There was no evidence of an interaction between intensity and duration. Among current smokers, the model including intensity alone had an R 2 of 0.24 and AUC of 0.697. The model adding duration had very similar results with an R 2 of 0.24 and AUC of 0.698. The model with pack-years had worse performance than the model with intensity alone, with an R 2 of 0.19 and AUC of 0.662. In the model pooling all participants, former smoking and duration were non-significant, while current smoking (HR 2.0, p<.001), intensity (HR packs/day 2.0, p<.001) and the interaction of former smoking status and intensity (HR 0.57, p=0.005) were significant. The interaction indicates that intensity is only important for current smokers. Other outcomes were also examined including coronary heart disease (CHD) and the findings were very consistent. Conclusions: For CVD risk, only current smoking intensity at baseline is significant. Adding duration to the model does not add information, and use of the pack-years variable results in a loss of information since it does not estimate the intensity effect as accurately. These results suggest that lowering or limiting current smoking would lower CVD risk, regardless of cumulative smoking exposure.

scholarly journals Comparison of Cardiovascular Disease Risks of Actual and Perceptions of Men’s that 40-65 Years Old

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
İbrahim Topuz ◽  
Sebahat Gozum
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Perceived Risk ◽  
Risk Perceptions ◽  
Smoking Status ◽  
Cvd Risk ◽  
Related Factors ◽  
Risk Reducing ◽  
Very High

Abstract Background Turkey is among the top countries in Europe in coronary mortality in the 45-74 age range. The highest death due to disorders of the circulatory system (50.8%) that is Amasya province. Objective Determine related factors and to compare with actual and perceived cardiovascular disease (CVD) risks of men aged 40-65 living in Amasya. Methods The sample size of cross-sectional and analytical study consisted of 400 people who met the inclusion criteria. Actual CVD risks of men were calculated using HeartScore. Age, systolic blood pressure, total cholesterol measured by blood taken from the capillary and smoking status were used to calculate CVD risk. Actual CVD risk in next decade has been calculated as low, medium, high or very high. Perceived CVD risk in next decade were identified by participants as low, medium, high and very high responses. They also questioned why evaluation of perceived risk. Results It was determined whereas 8.3% of the males had high, 52.5% had a very high level of CVD risk. The main variables affecting actual CVD risk; diastolic blood pressure, BMI and physical activity. 13.3% of males perceived CVD risks at high and 8% at very high. The main variables affecting perceived CVD risk; age and DM. It was found that 48% and 23.8% of males perceived CVD risks lower and higher than actual CVD risk while 28.2% were accurate. Those who perceived CVD risk at a moderate, high and very high think that this is caused by diseases that increase the risk of CVD and smoking. Conclusions Approximately 1/2 men has very high risk of CVD. It was determined that 1/2 men perceived risks are lower with false optimism and couldn’t accurately identify risks of people older and with diabetes. Key messages It can be ensured that develop risk reducing behaviors and individuals with high risk of CVD can raise their awareness. The risk perceptions of males in the very high-risk group from the past to the present are important because they affect their actual risks and risk-reducing behaviors.

scholarly journals Association of Xanthelasma palpebrarum (XP) with cardiovascular disease (CVD) risk factors

2020 ◽  
Vol 5 (4) ◽  
pp. 324-329
Author(s):  
AHM Khairul Imam Suman ◽  
Khadija Begum ◽  
Kaniz Rahman ◽  
Abu Mohammed Talukder ◽  
SM Matiur Rahman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cardiovascular Disease Risk Factors ◽  
Total Serum ◽  
Control Group ◽  
Total Serum Cholesterol ◽  
Xanthelasma Palpebrarum ◽  
Chi Square Analysis

Xanthelasma palpebrarum (XP) is the most common cutaneous xanthoma occurs over or surrounding the eyelids in yellowish color and various shapes. The objective of this study was to describe the status of cardiovascular disease risk factors in XP patients and determine their association with XP. A case-control study was conducted among 81 cases (have XP) and 81 controls (no XP) among patients attended for cardiac check-up between January 2019 to July 2019 at Ad-Din Women's Medical College Hospital, Dhaka, Bangladesh. Among 162 subjects were interviewed in our study, majority were female (62.3%). XP were found more prevalent among female and several cardiac risk factors were significantly associated with XP. The chi-square analysis indicates gender (p=0.035), BMI (p=0.01), Angina history (p=0.008), and serum LDL (p=0.024) were significantly associated with presence of XP. A higher percentage of patients with high total serum cholesterol, TG levels, and LDL was observed in patients with XP in compared to control group. Our study reveals an increased presence of cardiovascular disease risk factors among patients with xanthelasma. Moreover, a statistically significant association of gender, BMI, angina history, and serum LDL with XP were observed. Asian J. Med. Biol. Res. June 2019, 5(4): 324-329

scholarly journals Cardiovascular Disease Risk Prediction in Women: Is There a Role for Novel Biomarkers?

2014 ◽  
Vol 60 (1) ◽  
pp. 88-97 ◽  
Author(s):  
Nina P Paynter ◽  
Brendan M Everett ◽  
Nancy R Cook
Keyword(s):  
Cardiovascular Disease ◽  
Risk Prediction ◽  
Predictive Accuracy ◽  
Disease Risk ◽  
Troponin T ◽  
Cardiovascular Disease Risk ◽  
High Sensitivity ◽  
Preventive Therapy ◽  
Cvd Risk ◽  
Novel Biomarkers

Abstract BACKGROUND Risk prediction is an integral part of the current US guidelines for cardiovascular disease in women. Although current risk prediction algorithms exist to identify women at increased 10-year risk of cardiovascular disease (CVD), clinicians and researchers have been interested in developing novel biomarkers that might improve predictive accuracy further. These biomarkers have led to important insights into the pathophysiology of CVD, but results for their ability to improve prediction or guide preventive therapy have been mixed. The incidence of CVD is lower in women than men, and the effects of a number of traditional biomarkers on CVD risk differ in women compared to men. Both of these factors influence the ability to accurately predict CVD risk. CONTENT We review the distinctive aspects of CVD risk prediction in women, discuss the statistical challenges to improved risk prediction, and discuss a number of biomarkers in varying stages of development with a range of performance in prediction. SUMMARY A variety of biomarkers from different pathophysiologic pathways have been evaluated for improving CVD risk. While many have been incompletely studied or have not been shown to improve risk prediction in women, others, such as high-sensitivity troponin T, have shown promise in improving risk prediction. Increasing inclusion of women in CVD studies will be crucial to providing opportunities to evaluate future biomarkers.

scholarly journals A community based cross sectional study to estimate total cardiovascular risk in rural Punjab

2017 ◽  
Vol 4 (4) ◽  
pp. 1295
Author(s):  
Bibhava Vikramaditya ◽  
Mahesh Satija ◽  
Anurag Chaudhary ◽  
Sarit Sharma ◽  
Sangeeta Girdhar ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
High Risk ◽  
Risk Prediction ◽  
Cross Sectional Study ◽  
World Health ◽  
Sectional Study ◽  
Cvd Risk ◽  
Community Based ◽  
Cross Sectional

Background: Cardiovascular diseases (CVD) are leading cause of non communicable deaths in India. CVD risk prediction charts by World Health Organization/International Society of Hypertension (WHO/ISH) are designed for implementing timely preventive measures. The objective of the study was to assess the prevalence of CVD risk parameters and to estimate total CVD risk among adults aged ≥40 years, using the WHO/ISH risk charts alone and also to assess the effect of the inclusion of additional criteria on CVD risk.Methods: A community based cross sectional study was conducted in fifteen villages of Ludhiana district under rural health training centre of Department of Community Medicine, Dayanand Medical College & Hospital, Ludhiana, Punjab. Desired information was obtained using WHO STEPS survey (STEP wise approach to surveillance) from 324 adults aged ≥40 years. Anthropometric, clinical and laboratory measurements were also performed. WHO/ISH risk prediction chart for South East Asian region (SEAR-D) was used to assess the cardiovascular risk among the subjects.Results: WHO/ISH risk prediction charts identified 16.0% of the subjects with high risk (≥20%) of developing a cardiovascular event. The study population showed higher prevalence of physical inactivity, obesity, abdominal obesity, hypertension and diabetes. Amongst high risk CVD group, maximum prevalence was of hypertension and high perceived stress level. However, the proportion of high CVD risk (≥20%) increased to 33.6% when subjects with blood pressure ≥160/100 mmHg and /or on hypertension medication were added as high risk.Conclusions: A substantial proportion of this community is at high risk of developing cardiovascular diseases.

scholarly journals Primary Prevention of Cardiovascular Risk in Lithuania—Results from EUROASPIRE V Survey

Medicina ◽  
2020 ◽  
Vol 56 (3) ◽  
pp. 134
Author(s):  
Gediminas Urbonas ◽  
Lina Vencevičienė ◽  
Leonas Valius ◽  
Ieva Krivickienė ◽  
Linas Petrauskas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Primary Prevention ◽  
High Risk ◽  
Lipid Lowering ◽  
Blood Pressure Target ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Risk Patients ◽  
Very High

Background and Objectives: Cardiovascular disease (CVD) prevention guidelines define targets for lifestyle and risk factors for patients at high risk of developing CVD. We assessed the control of these factors, as well as CVD risk perception in patients enrolled into the primary care arm of the European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE V) survey in Lithuania. Materials and Methods: Data were collected as the part of the EUROASPIRE V survey, a multicenter, prospective, cross-sectional observational study. Adults without a documented CVD who had been prescribed antihypertensive medicines and/or lipid-lowering medicines and/or treatment for diabetes (diet and/oral antidiabetic medicines and/or insulin) were eligible for the survey. Data were collected through the review of medical records, patients’ interview, physical examination and laboratory tests. Results: A total of 201 patients were enrolled. Very few patients reached targets for low-density lipoprotein cholesterol (LDL-C) (4.5%), waist circumference (17.4%) and body mass index (15.4%). Only 31% of very high CVD risk patients and 52% of high-risk patients used statins. Blood pressure target was achieved by 115 (57.2%) patients. Only 21.7% of patients at very high actual CVD risk and 27% patients at high risk correctly estimated their risk. Of patients at moderate actual CVD risk, 37.5% patients accurately self-assessed the risk. About 60%–80% of patients reported efforts to reduce the intake of sugar, salt or alcohol; more than 70% of patients were current nonsmokers. Only a third of patients reported weight reduction efforts (33.3%) or regular physical activity (27.4%). Conclusions: The control of cardiovascular risk factors in a selected group of primary prevention patients was unsatisfactory, especially in terms of LDL-C level and body weight parameters. Many patients did not accurately perceive their own risk of developing CVD.

Abstract P028: High Framingham General Cardiovascular Disease Risk Scores in Victims of Out of Hospital Sudden Death

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Kyaw Khant ◽  
Mojtaba Mirzaei ◽  
Golsa Joodi ◽  
Brittany M Bogle ◽  
Jessica P Flowers ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
High Risk ◽  
Sudden Death ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Assessment Tools ◽  
Cvd Risk ◽  
Targeted Interventions ◽  
History Of ◽  
Wake County

Introduction: Individuals with a history of cardiovascular disease (CVD) have a high risk of out-of-hospital sudden unexpected death (OHSUD). However, most OHSUDs occur in victims without a prior history of CVD. Information on CVD risk in these victims is scarce. Hypothesis: We hypothesized that OHSUD victims who had no prior diagnosis of CVD have higher 10-year CVD risk compared to a matched living control population. Methods: OHSUD cases were adjudicated from all emergency medical service attended out-of-hospital deaths aged 30-64 in Wake County, NC between 2013-2015. Age group and gender-matched controls were randomly selected from Wake County residents who visited a local healthcare facility over the same period (~3:1 match ratio). We obtained two years of medical records prior to death (cases) or last visit (controls). After excluding individuals with a history of CVD, we calculated the 10-year risk of CVD for each subject using the published general CVD algorithms by D'Agostino et al. Risk was classified into low (<6%), moderate (6%-20%), and high (>20%). Results: Among subjects without CVD, we included 106 cases and 414 controls who had sufficient data for calculating Framingham risk score. Gender distribution was similar in both case and control groups. The average 10-year risk of CVD was higher for OHSUDs than controls (29% vs. 16%, p=<0.0001). Similar results were found in both men (34% vs. 19%, p=<0.0001) and women (11% vs. 7.3%, p=0.0005). A larger proportion of OHSUDs were considered “high risk” compared to controls (57% (60 of 106) vs. 28% (114 of 414), p=<0.001). This finding remained significant when stratified by gender (Figure). Conclusion: The majority of out of hospital sudden death victims without known CVD are at high risk of cardiovascular disease. This finding bolsters the essential role of office-based risk assessment tools in identifying high risk patients antemortem. Targeted interventions for intensive CVD risk reduction may lead to a decrease in sudden deaths.

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