Total cardiovascular risk management would require treating 5% of adults to avert 92 events per 100,000 annually, compared to treating 60% to avert 157 events with single-risk-factor management.
Cross-Sectional
Does total cardiovascular risk management improve cost-effectiveness compared to single-risk-factor management for the prevention of cardiovascular events in individuals aged 40-64 years?
Management based on high total cardiovascular risk optimizes the balance between the number requiring treatment and the number of events averted compared to single-risk-factor management.
OBJECTIVE: To assess the prevalence of cardiovascular (CV) risk factors in Seychelles, a middle-income African country, and compare the cost-effectiveness of single-risk-factor management (treating individuals with arterial blood pressure ≥ 140/90 mmHg and/or total serum cholesterol ≥ 6.2 mmol/l) with that of management based on total CV risk (treating individuals with a total CV risk ≥ 10% or ≥ 20%). METHODS: CV risk factor prevalence and a CV risk prediction chart for Africa were used to estimate the 10-year risk of suffering a fatal or non-fatal CV event among individuals aged 40-64 years. These figures were used to compare single-risk-factor management with total risk management in terms of the number of people requiring treatment to avert one CV event and the number of events potentially averted over 10 years. Treatment for patients with high total CV risk (≥ 20%) was assumed to consist of a fixed-dose combination of several drugs (polypill). Cost analyses were limited to medication. FINDINGS: A total CV risk of ≥ 10% and ≥ 20% was found among 10.8% and 5.1% of individuals, respectively. With single-risk-factor management, 60% of adults would need to be treated and 157 cardiovascular events per 100000 population would be averted per year, as opposed to 5% of adults and 92 events with total CV risk management. Management based on high total CV risk optimizes the balance between the number requiring treatment and the number of CV events averted. CONCLUSION: Total CV risk management is much more cost-effective than single-risk-factor management. These findings are relevant for all countries, but especially for those economically and demographically similar to Seychelles.
Ndindjock et al. (Thu,) conducted a cross-sectional in Cardiovascular risk. Total cardiovascular risk management vs. Single-risk-factor management was evaluated on Number of people requiring treatment to avert one CV event and number of events potentially averted over 10 years. Total cardiovascular risk management would require treating 5% of adults to avert 92 events per 100,000 annually, compared to treating 60% to avert 157 events with single-risk-factor management.