Key result
Global cardiovascular risk scores differentiate 10-year CVD risk with 63-86% accuracy.
Why the study?
Suitability and accuracy of cardiovascular 10-year risk scoring systems for medium- to low-resource countries, including Asian populations, remains challenging because most tools were developed from non-Asian cohorts.
What are the consolidated range values of internal and external validity and methodological perspectives of globally used CVD 10-year risk scores?
Systematic Review
What are the consolidated range values of internal and external validity and methodological perspectives of globally used CVD 10-year risk scores?
Globally used CVD risk scoring algorithms demonstrate fair to excellent validity (63-86% accuracy), but require updating and validation to improve performance and address gene-environment interactions, particularly for specific populations like Asians and those in low-to-middle-income countries.
Answers are grounded in this paper and cite their sources.
Supports use of global CVD risk scores for stratification now; confirms overall validity while extending need for population-specific updates.
Globally, the burden of cardiovascular disease is on the rise. Despite WHO’s and the UN’s frantic efforts, it appears less probable that the 25 by 25 aim will be met. Early identification of at-risk cases using a risk scoring system can aid in achieving these goals, however for primary and secondary prevention, suitability of these scoring systems, for the countries with medium to low resources, including Asians, with respect to accuracies is a challenge as majority of them are developed from non-Asian cohorts. In light of methodological considerations, risk attribution, and policy consequences, we included and described, restricting our search but sytematically, with five widely used global tools for CVD risk 10-year prediction—FRS, WHO CVD, QRISK, ASCVD, and SCORE—and their updated versions, altogether 11, published during 1970-2023. In general, the results of consolidated risk ratings and summarization showed that these algorithms can differentiate CVD 10-yr risk by 63-86% accurately, considering both for internal and external validity. Further, we discuss their methodological perspectives, ad hoc use, and suggest prospects. Registration Open Science Framework ( https://osf.io/72v48 ) Highlights Globally and optimally used cardiovascular disease (CVD) risk scoring algorithms have diverse accuracies, generalizability, and levels of evidence based on study designs, analyses, and given gold standards. Although validated fair to excellent, still the performance of these tools can be increased from 12 to 37%, both for internal and external accuracy, which can have a positive impact on cost and public health. Lifestyle and related changes due to gene-environment interaction, these algorithms are liable to change, so we need to update, validate, and fit them accordingly. Implementational, methodological, technological, and cost-related issues need to be addressed for a country or a state-specific algorithm to be up taken, updated, or validated.
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Adhikari et al. (2025) conducted a systematic review in Cardiovascular disease risk prediction. Cardiovascular 10-yr Risk Prediction Scores was evaluated on Accuracy (C-statistics) of CVD 10-yr risk prediction. Globally used cardiovascular risk scoring algorithms can accurately differentiate 10-year CVD risk by 63-86% considering both internal and external validity.
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