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January 1, 2013MEDICC ReviewOpen Access

Total Cardiovascular Risk Assessment and Management Using Two Prediction Tools, with and without Blood Cholesterol

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Key result

WHO/ISH charts without cholesterol achieve ~88% concordance with cholesterol-based charts, minimally overestimating drug needs.

  • n=1,287

Why the study?

Total cardiovascular risk assessment tools including and excluding blood cholesterol have been developed, but their applicability and concordance in middle-income countries like Cuba needed evaluation.

Does cardiovascular risk assessment using WHO/ISH charts without cholesterol provide concordant risk estimates and drug requirements compared to charts with cholesterol in adults aged 40-80?

Population

1287 persons aged 40-80 years in Havana, Cuba

Comparison

WHO/ISH risk prediction charts with cholesterol vs without cholesterol

Design

Cross-sectional study

Authors

PNP NordetSMShanthi MendisADAlfredo Dueñas

Discussion

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Member takes

Overview

Concordant estimates support cholesterol-free WHO/ISH charts in low-resource settings; leaves open prospective outcome validation before practice change.

Study Design

Type

Cross-Sectional (n=1,287)

Multicenter

No

Structured PICO

Does cardiovascular risk assessment using WHO/ISH charts without cholesterol provide concordant risk estimates and drug requirements compared to charts with cholesterol in adults aged 40-80?

P
Population
1,287 adults aged 40 to 80 years living in Havana, Cuba, underwent cardiovascular risk assessment to compare prediction tools with and without cholesterol.
E
Exposure
Cardiovascular risk assessment using WHO/International Society of Hypertension (WHO/ISH) risk prediction charts without blood cholesterol
C
Comparator
Cardiovascular risk assessment using WHO/ISH risk prediction charts with blood cholesterol
O
Outcome
Concordance between the two prediction charts for different risk levels and projected drug requirements

The WHO/ISH cardiovascular risk prediction chart without cholesterol shows high concordance (88.1%) with the cholesterol-inclusive chart, making it a viable tool for resource-limited settings without causing significant drug overprescription.

Limitations

  • Small sample size
  • WHO/ISH charts have not yet been validated internationally
  • Lack of country-specific cohort studies of CVD risk factors, morbidity and mortality in most low- and middle-income nations

Cite This Study

Nordet et al. (2013) conducted a cross-sectional in Cardiovascular risk (n=1,287). WHO/ISH cardiovascular risk prediction charts without cholesterol vs. WHO/ISH cardiovascular risk prediction charts with cholesterol was evaluated on Concordance of 10-year cardiovascular risk categories. Cardiovascular risk assessment using WHO/ISH charts without cholesterol demonstrated 88.1% concordance with charts including cholesterol, resulting in only a 2.6% overestimation of drug requirements.

synapsesocial.com/papers/6aaf73daa59802522a5d2fbfhttps://doi.org/10.37757/mr2013v15.n4.9
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Also Consider

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  2. 2Prediction of Coronary Heart Disease Using Risk Factor Categories1998 · 9,679 citations
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