Key result
Women present with ~67% lower baseline ASCVD risk scores than men despite prevalent risk factors.
Why the study?
The study aimed to assess modifiable cardiovascular disease risk factors among women versus men presenting for primary prevention at a tertiary care cardiac centre in Pakistan.
Are there differences in modifiable cardiovascular risk factors and estimated ASCVD risk scores between women and men presenting for primary prevention?
Observational (n=535)
No
Are there differences in modifiable cardiovascular risk factors and estimated ASCVD risk scores between women and men presenting for primary prevention?
Women presenting for primary prevention have a high prevalence of modifiable risk factors but significantly lower calculated ASCVD risk scores compared to men, suggesting potential discrepancies in risk estimation or the contribution of non-modifiable factors.
Answers are grounded in this paper and cite their sources.
Suggests ASCVD calculators may underestimate risk in women despite modifiable factors; leaves open need for sex-specific validation studies.
OBJECTIVE: The aim of this study was the assessment of modifiable risk factors of cardiovascular diseases (CVD) among women versus men at a newly developed preventive cardiology clinic of a large tertiary care cardiac centre in Pakistan. DESIGN: Observational study. SETTING: Tertiary care cardiac hospital in Karachi, Pakistan. PARTICIPANTS: Data for this study were obtained retrospectively from a prospectively collected ongoing registry. We have included all female and male individuals who have presented or were referred to our clinic for primary prevention. All the participants had no history of ischaemic heart disease. OUTCOME MEASURE: In this study, we evaluated the CVD risk factors, estimated risk of CVD, and glycaemic and cholesterol control at baseline and at subsequent follow-ups for high-risk patients. RESULTS: , respectively.Baseline atherosclerotic cardiovascular disease (ASCVD) risk score was available for 348 (65%), 61.5% (136) of men versus 67.5% (212) of women. The median ASCVD risk score was 6.8% (2.8%-16.1%) vs 2.25% (1%-5.1%) (p<0.001 for men and women, respectively). The ASCVD risk score was ≥20% (high risk) for 22.1% (30) vs 1.9% (4), while the ASCVD risk score was <5% (low risk) for 40.4% (55) vs 74.1% (157) of men and women, respectively.A repeat ASCVD assessment at a median follow-up of 49.5 (7.0-231) days was available for 259 (48.4%) patients, 26.2% (58) of men vs 64% (201) of women, respectively. The median follow-up ASCVD score was 6.55% (2.8%-15.4%) vs 2.1% (0.9%-4.8%) (p<0.001 with ≥20% (high risk) in 19% (11) vs 2% (4) and <5% (low risk) in 34.5% (20) vs 77.1% (155) of men and women, respectively). CONCLUSIONS: There is a high prevalence of modifiable risk factors for atherosclerotic CVD such as HTN, diabetes and obesity in women as compared with men, but interestingly, ASCVD risk score at the baseline as well as at the follow-up is high in men versus women. Some other non-modifiable risk factors like age, gender and blood lipid profile may also contribute to this difference between the high prevalence of risk factors and low ASCVD risk score in women. With appropriate follow-up and proper counselling, the looming CVD can be better prevented in this population. A dedicated preventive cardiology clinic for the identification of high-risk women and systematic follow-up is needed to predict their actual CVD risk. TRIAL REGISTRATION: NCT06503341.
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Rauf et al. (2024) conducted an observational in Cardiovascular disease primary prevention (n=535). Women vs. Men was evaluated on Baseline ASCVD risk score (p=<0.001). Women presenting for primary prevention had a lower median baseline ASCVD risk score compared to men, despite a high prevalence of modifiable risk factors.
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