TY - JOUR
T1 - A novel risk score to predict cardiovascular disease risk in national populations (Globorisk)
T2 - A pooled analysis of prospective cohorts and health examination surveys
AU - Hajifathalian, Kaveh
AU - Ueda, Peter
AU - Lu, Yuan
AU - Woodward, Mark
AU - Ahmadvand, Alireza
AU - Aguilar-Salinas, Carlos A.
AU - Azizi, Fereidoun
AU - Cifkova, Renata
AU - Di Cesare, Mariachiara
AU - Eriksen, Louise
AU - Farzadfar, Farshad
AU - Ikeda, Nayu
AU - Khalili, Davood
AU - Khang, Young Ho
AU - Lanska, Vera
AU - León-Muñoz, Luz
AU - Magliano, Dianna
AU - Msyamboza, Kelias P.
AU - Oh, Kyungwon
AU - Rodríguez-Artalejo, Fernando
AU - Rojas-Martinez, Rosalba
AU - Shaw, Jonathan E.
AU - Stevens, Gretchen A.
AU - Tolstrup, Janne
AU - Zhou, Bin
AU - Salomon, Joshua A.
AU - Ezzati, Majid
AU - Danaei, Goodarz
N1 - Publisher Copyright:
© 2015 Elsevier Ltd.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Background: Treatment of cardiovascular risk factors based on disease risk depends on valid risk prediction equations. We aimed to develop, and apply in example countries, a risk prediction equation for cardiovascular disease (consisting here of coronary heart disease and stroke) that can be recalibrated and updated for application in different countries with routinely available information. Methods: We used data from eight prospective cohort studies to estimate coefficients of the risk equation with proportional hazard regressions. The risk prediction equation included smoking, blood pressure, diabetes, and total cholesterol, and allowed the effects of sex and age on cardiovascular disease to vary between cohorts or countries. We developed risk equations for fatal cardiovascular disease and for fatal plus non-fatal cardiovascular disease. We validated the risk equations internally and also using data from three cohorts that were not used to create the equations. We then used the risk prediction equation and data from recent (2006 or later) national health surveys to estimate the proportion of the population at different levels of cardiovascular disease risk in 11 countries from different world regions (China, Czech Republic, Denmark, England, Iran, Japan, Malawi, Mexico, South Korea, Spain, and USA). Findings: The risk score discriminated well in internal and external validations, with C statistics generally 70% or more. At any age and risk factor level, the estimated 10 year fatal cardiovascular disease risk varied substantially between countries. The prevalence of people at high risk of fatal cardiovascular disease was lowest in South Korea, Spain, and Denmark, where only 5-10% of men and women had more than a 10% risk, and 62-77% of men and 79-82% of women had less than a 3% risk. Conversely, the proportion of people at high risk of fatal cardiovascular disease was largest in China and Mexico. In China, 33% of men and 28% of women had a 10-year risk of fatal cardiovascular disease of 10% or more, whereas in Mexico, the prevalence of this high risk was 16% for men and 11% for women. The prevalence of less than a 3% risk was 37% for men and 42% for women in China, and 55% for men and 69% for women in Mexico. Interpretation: We developed a cardiovascular disease risk equation that can be recalibrated for application in different countries with routinely available information. The estimated percentage of people at high risk of fatal cardiovascular disease was higher in low-income and middle-income countries than in high-income countries. Funding: US National Institutes of Health, UK Medical Research Council, Wellcome Trust.
AB - Background: Treatment of cardiovascular risk factors based on disease risk depends on valid risk prediction equations. We aimed to develop, and apply in example countries, a risk prediction equation for cardiovascular disease (consisting here of coronary heart disease and stroke) that can be recalibrated and updated for application in different countries with routinely available information. Methods: We used data from eight prospective cohort studies to estimate coefficients of the risk equation with proportional hazard regressions. The risk prediction equation included smoking, blood pressure, diabetes, and total cholesterol, and allowed the effects of sex and age on cardiovascular disease to vary between cohorts or countries. We developed risk equations for fatal cardiovascular disease and for fatal plus non-fatal cardiovascular disease. We validated the risk equations internally and also using data from three cohorts that were not used to create the equations. We then used the risk prediction equation and data from recent (2006 or later) national health surveys to estimate the proportion of the population at different levels of cardiovascular disease risk in 11 countries from different world regions (China, Czech Republic, Denmark, England, Iran, Japan, Malawi, Mexico, South Korea, Spain, and USA). Findings: The risk score discriminated well in internal and external validations, with C statistics generally 70% or more. At any age and risk factor level, the estimated 10 year fatal cardiovascular disease risk varied substantially between countries. The prevalence of people at high risk of fatal cardiovascular disease was lowest in South Korea, Spain, and Denmark, where only 5-10% of men and women had more than a 10% risk, and 62-77% of men and 79-82% of women had less than a 3% risk. Conversely, the proportion of people at high risk of fatal cardiovascular disease was largest in China and Mexico. In China, 33% of men and 28% of women had a 10-year risk of fatal cardiovascular disease of 10% or more, whereas in Mexico, the prevalence of this high risk was 16% for men and 11% for women. The prevalence of less than a 3% risk was 37% for men and 42% for women in China, and 55% for men and 69% for women in Mexico. Interpretation: We developed a cardiovascular disease risk equation that can be recalibrated for application in different countries with routinely available information. The estimated percentage of people at high risk of fatal cardiovascular disease was higher in low-income and middle-income countries than in high-income countries. Funding: US National Institutes of Health, UK Medical Research Council, Wellcome Trust.
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U2 - 10.1016/S2213-8587(15)00081-9
DO - 10.1016/S2213-8587(15)00081-9
M3 - Article
C2 - 25819778
AN - SCOPUS:84928706403
SN - 2213-8587
VL - 3
SP - 339
EP - 355
JO - The Lancet Diabetes and Endocrinology
JF - The Lancet Diabetes and Endocrinology
IS - 5
ER -