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Published on: September 26, 2018
Cardiovascular risk assessment: a global perspective
Dong Zhao1, Jing Liu1, Wuxiang Xie1
1Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Institute of Heart, Lung and Blood Vessel Diseases, 2 Anzhen Road, Chaoyang District, Beijing 100029, China.
Insights
Early identification of cardiovascular disease (CVD) risk is crucial for primary prevention. This review examines global CVD risk assessment models and guidelines, highlighting limitations for non-Western populations and guiding low-to-middle-income countries.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Cardiovascular diseases (CVD) pose a significant global health burden.
- Early identification of high-risk individuals is key for primary CVD prevention.
- Current CVD risk-assessment models are often region-specific (e.g., USA, Europe).
Purpose of the Study:
- To review the global landscape of CVD risk-assessment models and clinical guidelines.
- To address the limitations of existing models for diverse geographical regions and ethnic populations.
- To provide guidance for developing and validating region-specific CVD risk-assessment tools.
Main Methods:
- Review of existing CVD risk-assessment models and clinical guidelines.
- Analysis of model applicability across different geographical regions and ethnic groups.
- Comparison of risk-assessment recommendations in developed versus developing countries.
Main Results:
- Many established CVD risk models may not be suitable for populations outside the USA and Europe.
- There is a need for localized CVD risk-assessment tools and guidelines.
- Clinical guidelines show significant differences between developed and developing nations.
Conclusions:
- Global CVD risk assessment requires tailored approaches beyond existing Western-centric models.
- Low-to-middle-income countries need support in developing or validating local CVD risk-assessment models.
- Adapting clinical guidelines to local requirements is essential for effective CVD prevention.
Abstract:
An important strategy in primary prevention of cardiovascular diseases (CVD) is the early identification of high-risk individuals. Effective implementation of a strategy to identify these individuals in a clinical setting is reliant on the availability of appropriate CVD risk-assessment models and guideline recommendations. Several well-known models for CVD risk assessment have been developed and utilized in the USA and Europe, but might not be suitable for use in other regions or countries. Very few reports have discussed the development of risk-assessment models and recommendations from a global perspective. In this Review, we discuss why risk-assessment methods developed from studies in one geographical region or ethnic population might not be suitable for other regions or populations, and examine the availability and characteristics of predictive models in areas beyond the USA or Europe. In addition, we compare the differences in risk-assessment recommendations outlined in CVD clinical guidelines from developed and developing countries, and consider their potential effect on clinical practice. This overview of cardiovascular risk assessment from a global perspective can potentially guide low-to-middle-income countries in the development or validation of their own CVD risk-assessment models, and the formulation of recommendations in their own clinical guidelines according to local requirements.
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