Decade of Risk: Predicting Ten-year Cardiovascular Disease Events (Stroke/myocardial Infarction) in Hypertensive...

Non-communicable diseases (NCDs) disproportionately impact low- and middle-income countries. In India, cardiovascular diseases (CVDs) lead in mortality and disability, driven by tobacco use, poor diet, and inactivity. Large-scale prevention remains limited.

This study aims to identify CVD risk factors and estimate the 10-year risk of stroke or myocardial infarction (MI) among hypertensive patients attending the Medicine outpatient department (OPD) at All India Institute of Medical Sciences (AIIMS), Deoghar, India.

This cross-sectional study was conducted in the Medicine OPD of AIIMS Deoghar, Jharkhand, from February to June 2024, including 365 hypertensive patients aged ≥30 years selected through purposive sampling. Eligibility criteria and recruitment procedures were predefined. Data were collected using a pre-tested structured questionnaire covering sociodemographic, clinical, and behavioral factors. Blood pressure was measured using a calibrated mercury sphygmomanometer under standard conditions, and laboratory investigations (random blood sugar [RBS] and lipid profile) were performed as per hospital protocols. The primary outcome was the 10-year CVD risk estimated using QRISK 3, with relevant variables systematically recorded. The 10-year CVD risk was estimated using the QRISK3, a validated risk prediction tool originally developed in the United Kingdom. It calculates individual risk of developing CVD (including MI and stroke) based on multiple variables such as age, sex, smoking status, systolic blood pressure, total cholesterol/high-density lipoprotein (HDL) ratio, and comorbid conditions (e.g., diabetes, chronic kidney disease, atrial fibrillation, and rheumatoid arthritis). The algorithm provides an absolute 10-year risk percentage to guide cardiovascular risk stratification and preventive decision-making. Data were analyzed using SPSS version 22. Continuous variables were expressed as mean ± SD and categorical variables as proportions. Associations were assessed using Chi-square and Pearson's correlation. A P value < 0.05 was considered significant. Bias was minimized through standardized measurements and predefined criteria. Ethical approval was obtained from Institutional Ethics Committee (IEC) and Institutional Review Committee (IRC), AIIMS Deoghar, and written informed consent was taken from all participants.

The study included 57.8% male and 42.2% female participants. Smoking prevalence was high (88.8%), and 22.7% of participants had diabetes. Uncontrolled hypertension was present in 21.6%, with 20.8% receiving treatment. The mean 10-year QRISK3 score was 11.67 (SD = 11.16), with a relative risk mean of 1.53 (SD = 1.01). The mean QRISK3 Healthy Heart Age was 58.68 years (SD = 12.44), indicating a substantial deviation from optimal cardiovascular health. Correlation analysis revealed significant associations between age, systolic blood pressure, and RBS with CVD risk scores.

Among hypertensive patients attending a tertiary-care center in Jharkhand, the mean 10-year QRISK3-estimated cardiovascular event risk was 11.67%, indicating a moderate-risk profile. Age, systolic blood pressure, glycemic status, and lipid abnormalities were the major contributors to risk. These findings highlight the need for routine cardiovascular risk assessment, optimal blood pressure control, smoking cessation, and improved diabetes management to reduce future stroke and MI risk.