scholarly journals Cardiovascular risk in primary care: comparison between Framingham Score and waist circumference

2021 ◽  
Vol 11 (4) ◽  
pp. 53-60
Author(s):  
Nina Vitória de Souza Silva Andrade ◽  
Isis Marinho de Noronha ◽  
Larisse Xavier Almeida ◽  
Fernanda Siqueira ◽  
Tatiana Onofre

Objectives: To estimate and compare the cardiovascular risk using the Framingham risk score (FRS) and waist circumference (WC) in primary care individuals and, secondarily, determine the main factors associated with these scores. Methods: Cross-sectional study involving individuals of both sexes attended in a primary health unit and aging between 30 and 74 years. The cardiovascular risks (FRS and WC) were stratified as low, intermediate, and high. The weighted Kappa coefficient was used to assess agreements between scores. Results: Fifty-five individuals (52.8 ± 9.4 years, 70.9% women) were evaluated. Using the FRS, 40.0% of the sample presented a low risk, 45.5% intermediate risk, and 14.5% high risk of cardiovascular disease. Conversely, when analyzed using the WC score, the highest frequency (71%) was observed in the high-risk category. Also, no agreement (K= 0.36; p= 0.55) was found between scores. FRS was associated with hypertension (p<0.01), diabetes (p=0.01), and stress in women (p=0.01), while the WC score was associated with hypertension (p=0.02), obesity (p<0.01), and high-density lipoprotein cholesterol HDL-c (p=0.03). Conclusions: Primary care individuals presented intermediate cardiovascular risk in the FRS and high risk in the WC, with no agreement between scores. Hypertension, diabetes, stress, obesity, and HDL-c represented the factors that were most associated with these scores.

Author(s):  
Maria do Carmo Lacerda Barbosa ◽  
José Bonifácio Barbosa ◽  
Luis Felipe Alves Guerra ◽  
Mirza Ferreira Lima Barbosa ◽  
Felipe Lacerda Barbosa ◽  
...  

Objective: to evaluate the prevalence of cardiovascular risk factors associated with dyslipidemia in Quilombola communities in Maranhão, Brazil. Methods: a cross-sectional study was performed from February 2010 to November 2011. A total of 202 individuals belonging to the Quilombola communities in Codó, Maranhão were assessed. Risk factors associated with dyslipidemia and metabolic syndrome (MS) were evaluated. Results: the results showed a high prevalence of dyslipidemia (72.28%) and hypertension (43.07%). Isolated hypertriglyceridemia (38.61%) with normal levels of high-density lipoprotein cholesterol and low-density lipoprotein cholesterol was present in most individuals. Furthermore, the prevalence of MS and the estimated cardiovascular risks were low in this population. Conclusion: dyslipidemia, at the expense of triglycerides, and hypertension was highly prevalent. However, the frequency of other risk factors for cardiovascular events was low. A low prevalence of MS and cardiovascular risk according to the Framingham score for cardiovascular diseases was also identified.


BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e017711 ◽  
Author(s):  
Su May Liew ◽  
Wai Khew Lee ◽  
Ee Ming Khoo ◽  
Irmi Zarina Ismail ◽  
Subashini Ambigapathy ◽  
...  

ObjectiveAccurate cardiovascular risk estimations by patients and doctors are important as these affect health behaviour and medical decision making. We aimed to determine if doctors and patients were accurately estimating the absolute cardiovascular risk of patients in primary care.MethodsA cross-sectional study was carried out in primary care clinics in Malaysia in 2014. Patients aged 35 years and above without known cardiovascular disease (CVDs) were included. Face-to-face interviews with a structured questionnaire were used to collect sociodemographic and clinical data as well as patients’ perception and doctors’ estimate of the patients’ CVD risk. Associations were tested using χ2, correlation and independent t-tests.ResultsWe recruited 1094 patients and 57 doctors. Using the Framingham Risk Score (FRS) alone, 508 patients (46.4%) were in the high-risk group. When diabetes was included as high risk, the number increased to 776 (70.9%). Only 34.4% of patients and 55.7% of doctors correctly estimated the patient’s CVD risk in comparison with the reference FRS.Of the high-risk patients, 664 (85.6%) underestimated their CV risk. Factors associated with underestimation by patients included not having family history of CVD (adjusted OR (AOR): 2.705, 95% CI 1.538 to 4.757), smaller waist circumference (AOR: 0.979,95% CI 0.960 to 0.999) and ethnicity in comparison with the Malay as reference group (indigenous/others: AOR: 0.129, 95% CI 0.071 to 0.235). Doctors underestimated risk in 59.8% of the high-risk group. Factors associated with underestimation by doctors were patients factors such as being female (AOR: 2.232, 95% CI 1.460 to 3.410), younger age (AOR: 0.908, 95% CI 0.886 to 0.930), non-hypertensive (AOR: 1.731, 95% CI 1.067 to 2.808), non-diabetic (AOR: 1.931, 95% CI 1.114 to 3.348), higher high-density lipoprotein levels (AOR: 3.546, 95% CI 2.025 to 6.209), lower systolic blood pressure (AOR: 0.970, 95% CI 0.957 to 0.982), non-smoker (AOR: 2.246, 95% CI 1.354 to 3.726) and ethnicity in comparison with the Malay as reference group (Indian: AOR: 0.430, 95% CI 0.257 to 0.720; indigenous/others: AOR: 2.498, 95% CI 1.346 to 4.636).ConclusionsThe majority of consultations occurring between doctors and patients are being informed by inaccurate cardiovascular risk estimation.


PLoS ONE ◽  
2011 ◽  
Vol 6 (9) ◽  
pp. e25032 ◽  
Author(s):  
Peter M. Janiszewski ◽  
Robert Ross ◽  
Jean-Pierre Despres ◽  
Isabelle Lemieux ◽  
Gabriella Orlando ◽  
...  

Author(s):  
Sienny Linawaty ◽  
JB. Suparyatmo ◽  
Tahono Tahono

Coronary Artery Disease has a high prevalence and is frequently occurred and associated with the high mortality and morbidity. Dyslipidemia is one of the risk factors of Coronary Heart Disease (CHD). ApoB contained in very low-density lipoproteins (VLDL), intermediate-density lipoproteins (IDL), LDL and small dense LDL (sd-LDL), with one molecule of apoB in each particle. Apo A-I is the major apolipoprotein in HDL particles. The ratio of apoB/apoA-I is a balance between apoB-containing particles and potentially atherogenic apoA-I that is antiaterogenik. This study is carried to know the determination whether there are differences between apoB/ apoA-I ratio in patients dyslipidemia with ACS and non ACS. The research used a cross-sectional study design with patients dyslipidemia subjects suffering Acute Coronary Syndrome (ACS) and non ACS who enter to the Laboratory of Pathology Clinic at Dr. Moewardi Hospital between July and November 2011. To determine the pattern of data distribution, the researchers used Kolmogorov Smirnov test. For the analysis of differences in mean apoB/apoA-I ratio in the two population groups is used the T test, using a computer program, with the significance level p<0.05, 95% confidence interval. From 74 samples examined the mean age is 56.42 year old. This patients consisted of 33 males (44.6%) and 41 women (55.4%). All subjects are grouped into two groups, dyslipidemia ACS and non dyslipidemia ACS. The results showed apoB/apoA-I ratio significantly different in patients with dyslipidemia with ACS and non ACS. The mean apoB/apoA-I ratio of women and men subjects in both groups, including groups at high risk of myocardial myokard and higher than the cut-off ratio of apoB/ apoA-I (men 0.9 and women 0.8). It can be concluded that the apoB/apoA-I ratio of women and men subjects in both groups, included the high risk category for infarct myokard although lipid abnormalities are still not demonstrated to the risk of infarct myokard.


2020 ◽  
Author(s):  
Yan Liu ◽  
Zhenwen Zhang ◽  
Binlan Xia ◽  
Liping Wang ◽  
Hengzhong Zhang ◽  
...  

Abstract Background: Evidence on the association between the non-high-density lipoprotein cholesterol (non-HDLc)-to-high-density lipoprotein cholesterol (HDLc) ratio (non-HDLc/HDLc) and carotid plaques is still limited. This study aims to assess the relationship between the non-HDLc/HDLc and carotid plaques in a population with a high risk of stroke.Methods: A cross-sectional study based on the community was conducted in Yangzhou, China. Residents (no younger than 40 years old) underwent questionnaire interviews, physical examinations, and laboratory testing during 2013-2014. The subjects with a high risk of stroke were further selected (at least three of eight risk factors including hypertension, atrial fibrillation, type 2 diabetes mellitus, dyslipidaemia, smoking, lack of exercise, overweight, and family history of stroke) or a transient ischaemic attack (TIA) or stroke history. Carotid ultrasonography was then performed on the high stroke risk participants. Carotid plaque was defined as a focal carotid intima-media thickness (cIMT) ≥1.5 cm or a discrete structure protruding into the arterial lumen at least 50% of the surrounding cIMT. Logistic regression was employed to evaluate the relationship between the non-HDLc/HDLc and carotid plaques.Results: Overall, 839 subjects with a high risk of stroke were ultimately included in the analysis, and carotid plaques were identified in 341 (40.6%) of them. Participants in the highest non-HDLc/HDLc tertile group presented a higher proportion of carotid plaques than did those in the other two groups. After adjustment for other confounders, each unit increase in the non-HDLc/HDLc was significantly associated with carotid plaques (OR 1.55, 95%CI 1.28-1.88). In the subgroup analysis, the non-HDLc/HDLc was positively and significantly associated with the presence of carotid plaques in most subgroups. Additionally, the non-HDLc/HDLc interacted significantly with three stratification variables, including sex (OR 1.31 for males vs. OR 2.37 for females, P interaction = 0.016), exercise (OR 1.18 for subjects without lack of exercise vs. OR 1.99 for subjects with lack of exercise, P interaction = 0.004) and heart diseases (OR 1.40 for subjects without heart diseases vs. OR 3.12 for subjects with heart diseases, P interaction = 0.033). Conclusion: The non-HDLc/HDLc was positively associated with the presence of carotid plaques in a Chinese high stroke risk population. A prospective study or randomized clinical trial of lipid-lowering therapy in the Chinese population is needed to evaluate their causal relationship.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Grzegorz Gielerak ◽  
Paweł Krzesiński ◽  
Katarzyna Piotrowicz ◽  
Piotr Murawski ◽  
Andrzej Skrobowski ◽  
...  

The MIL-SCORE (Equalization of Accessibility to Cardiology Prophylaxis and Care for Professional Soldiers) program was designed to assess the prevalence and management of cardiovascular risk factors in a population of Polish soldiers. We aimed to describe the prevalence of cardiovascular risk factors in the MIL-SCORE population with respect to age. This observational cross-sectional study enrolled 6440 soldiers (97% male) who underwent a medical history, physical examination, and laboratory tests to assess cardiovascular risk. Almost half of the recruited soldiers were past or current smokers (46%). A sedentary lifestyle was reported in almost one-third of those over 40 years of age. The prevalence of hypertension in a subgroup over 50 years of age was almost 45%. However, the percentage of unsatisfactory blood pressure control was higher among soldiers below 40 years of age. The prevalence of overweight and obese soldiers increased with age and reached 58% and 27%, respectively, in those over 50 years of age. Total cholesterol was increased in over one-half of subjects, and the prevalence of abnormal low-density lipoprotein cholesterol was even higher (60%). Triglycerides were increased in 36% of soldiers, and low high-density lipoprotein cholesterol and hyperglycemia were reported in 13% and 16% of soldiers, respectively. In the >50 years of age subgroup, high and very high cardiovascular risk scores were observed in almost one-third of soldiers. The relative risk assessed in younger subgroups was moderate or high. The results from the MIL-SCORE program suggest that Polish soldiers have multiple cardiovascular risk factors and mirror trends seen in the general population. Preventive programs aimed at early cardiovascular risk assessment and modification are strongly needed in this population.


Author(s):  
Bibhava Vikramaditya ◽  
Mahesh Satija ◽  
Anurag Chaudhary ◽  
Sarit Sharma ◽  
Sangeeta Girdhar ◽  
...  

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.


Author(s):  
Basavaraj S. Mannapur ◽  
Bhagyalaxmi S. Sidenur ◽  
Ashok S. Dorle

Background: Diabetes is considered as a global emergency where a person dies from diabetes every 6 seconds and diabetes is seen on 1 in 11 adults. Identification of individuals who are at risk is very much necessary to prevent diabetes in India. IDRS could also help to detect people at risk of having prediabetes. The objective of the study were to estimate the prevalence of diabetes mellitus in the age group of >20 years in urban field practice area of S.N. Medical college, Bagalkot and to identify high risk subjects using Indian diabetes risk score (IDRS).Methods: A cross sectional study was done in urban field practice area of S.N. Medical College among adults >20 years of age with sample size of 207. Systematic random sampling was used to select the subjects. Data was collected using standardised questionnaire which included socio-demographic profile, standard glucometer was used to measure random blood glucose for all participants. IDRS was used to ascertain the risk of developing diabetes. Data was analysed using Pearson’s Chi square test and Fischer exact.Results: The overall prevalence of diabetes was 14.1%. Among 206 subjects, 4.8% were in low risk category. 39.6% and 55.1% were in moderate and high risk category respectively. Total of 11 subjects were newly diagnosed in our study. Among them 10 subjects were in the high risk category and 1 was in the low risk category. Sensitivity of IDRS was 90%, specificity 50%, positive predictive value 43.8% and negative predictive value 96.74%..Conclusions: This study estimates the usefulness of simplified Indian diabetes risk score for identifying high risk diabetic subjects in the community. It can be used routinely in commu­nity-based screening to find out high risk people for diabetes so that proper intervention can be done to reduce the burden of the disease. 


Author(s):  
Mareeswaran N. ◽  
R. Umadevi ◽  
A. K. Savitha

Background: Diabetes mellitus is a major public health problem. Non communicable diseases like coronary artery disease (CAD), stroke, obesity are increasing in number and overtakes the communicable diseases with respect to morbidity and mortality. Diabetic populations have a higher risk of developing CAD than the general population. The aim of this study was to assess the risk of developing cardiovascular diseases among diabetic patients.Methods: This is a cross sectional study done among the urban adult population in Kancheepuram district. Sample size of 400 diabetic patients was studied by using consecutive sampling method. Data was collected by administering a pre tested structured questionnaire. Cardiovascular risk was assessed based on PROCAM scoring, a 10 years risk assessment score. The study was done for a period of three months from January to March 2018. Data analysis was done in SPSS software version 22.Results: Among the diabetic patients, 53.5% of them are in high risk category based on PROCAM score for developing cardiovascular disease. A statistical significant association was found between cardiovascular risk and factors like socioeconomic status and overweight/obesity.Conclusions: This study reveals that the diabetic populations are at higher risk of developing cardiovascular diseases. Hence awareness about the risk should be created and appropriate intervention at early stages should be implemented at primary health care level. 


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