New Cardiovascular Risk Score Has Unprecedented Accuracy Worldwide

A new cardiovascular (CV) risk estimator can accurately predict heart disease and stroke risk for anyone in the world aged 40 years or older.

The algorithm, called Globorisk, calculates an individual’s 10-year CV risk by factoring in smoking status, blood pressure, diabetes status, and total cholesterol level, while adjusting for the effects of sex and age on cardiovascular disease among countries. The resulting risk score can easily be updated and recalibrated as new information becomes available.

To develop and validate the risk score, investigators used data from 8 prospectively designed cohort studies that were conducted no earlier than 2006 and included more than 50,000 total participants. Using recent national health surveys, they recalibrated and applied their risk score to 11 countries from different world regions.

While developing country-specific risk charts, the researchers found substantial differences in CV risk among countries, with populations at the lowest risk for fatal CV disease residing in high-income countries such as South Korea, Spain, and Denmark. In these 3 countries, approximately two-thirds of men and more than three-fourths of women have a <3% risk of experiencing a fatal heart attack or stroke within 10 years.

Contrasting with these high-income countries, the populations of low-income countries such as China and Mexico have the highest risk of fatal CV events, the investigators discovered. In China, approximately one-third of men and more than one-fourth of women have an estimated 10% risk of experiencing a CV event at some point in the next decade. Conversely, just more than one-third of men and fewer than half of women in China have a <3%10-year risk of experiencing CV events.

Although women in Mexico fared better, with more than two-thirds having a <3% risk of CV events in 10 years, just over half of men had a 10-year risk at this level.

All of these risk calculators are represented in a set of easy-to-use charts published in The Lancet Diabetes & Endocrinology alongside the research findings.

“Globorisk is an important advance in the field of global cardiovascular disease prevention. Until now, most prediction scores were developed using a single cohort study and were never validated for accuracy in national populations for low- and middle-income countries,” said lead investigator Goodarz Danaei, MD, assistant professor of global health at the Harvard TH Chan School of Public Health, in a press release. “…By estimating the number of people who have a high risk in any given country, we have more chance of accurately measuring progress towards the [World Health Organization] target of 50% coverage of multidrug treatment and counseling for people aged 40 years and older at high risk of cardiovascular disease.”

With an increasing emphasis on the use of CV risk estimators in guiding treatment decisions, and researchers questioning the accuracy of these risk calculators in patients of different ethnic backgrounds, it is important to base treatment decisions on the most accurate data possible. Because CV risk varies greatly in patients from different backgrounds, the Globorisk calculator offers unprecedented accuracy in guiding treatment decisions for patients in different world regions.

References

1. Hajifathalian K, Ueda P, Lu Y, et al. A novel risk score to predict cardiovascular disease risk in national populations (Globorisk): a pooled analysis of prospective cohorts and health examination surveys. Lancet Diabetes Endocrinol. 2015. doi: 10.1016/S2213-8587(15)00081-9.

2. New score predicts heart disease and stroke risk for anyone in world aged over 40. ScienceDaily website. www.sciencedaily.com/releases/2015/03/150325210357.htm. Accessed March 2015.