Please use this identifier to cite or link to this item: https://hdl.handle.net/10321/907
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dc.contributor.authorGaziano, Thomas A.en_US
dc.contributor.authorPandya, Ankuren_US
dc.contributor.authorSteyn, Kriselaen_US
dc.contributor.authorLevitt, Naomien_US
dc.contributor.authorMollentze, Willieen_US
dc.contributor.authorJoubert, Ginaen_US
dc.contributor.authorWalsh, Corinna Men_US
dc.contributor.authorMotala, Ayesha A.en_US
dc.contributor.authorKruger, Annamarieen_US
dc.contributor.authorSchutte, Aletta E.en_US
dc.contributor.authorNaidoo, Datshana Prakashen_US
dc.contributor.authorPrakaschandra, Dorcas Rosaleyen_US
dc.contributor.authorLaubscher, Riaen_US
dc.date.accessioned2013-09-16T13:54:20Z-
dc.date.available2013-09-16T13:54:20Z-
dc.date.issued2013-07-24-
dc.identifier.citationGaziano, T.A., Pandya, A., Steyn, K., Levitt, N., Mollentze, W., Joubert, G., Walsh, C.M.,,Motala, A.A., Kruger, A., Schutte, A.E.; Naidoo, D.P.; Prakaschandra, D.R. and Laubscher, R. 2013. Comparative assessment of absolute cardiovascular disease risk characterization from non-laboratory- based risk assessment in South African populations. BMC Medicine, 11(170).en_US
dc.identifier.urihttp://hdl.handle.net/10321/907-
dc.description.abstractBackground All rigorous primary cardiovascular disease (CVD) prevention guidelines recommend absolute CVD risk scores to identify high- and low-risk patients, but laboratory testing can be impractical in low- and middle-income countries. The purpose of this study was to compare the ranking performance of a simple, non-laboratory-based risk score to laboratory-based scores in various South African populations. Methods We calculated and compared 10-year CVD (or coronary heart disease (CHD)) risk for 14,772 adults from thirteen cross-sectional South African populations (data collected from 1987 to 2009). Risk characterization performance for the non-laboratory-based score was assessed by comparing rankings of risk with six laboratory-based scores (three versions of Framingham risk, SCORE for high- and low-risk countries, and CUORE) using Spearman rank correlation and percent of population equivalently characterized as ‘high’ or ‘low’ risk. Total 10-year non-laboratory-based risk of CVD death was also calculated for a representative cross-section from the 1998 South African Demographic Health Survey (DHS, n = 9,379) to estimate the national burden of CVD mortality risk. Results Spearman correlation coefficients for the non-laboratory-based score with the laboratory-based scores ranged from 0.88 to 0.986. Using conventional thresholds for CVD risk (10% to 20% 10-year CVD risk), 90% to 92% of men and 94% to 97% of women were equivalently characterized as ‘high’ or ‘low’ risk using the non-laboratory-based and Framingham (2008) CVD risk score. These results were robust across the six risk scores evaluated and the thirteen cross-sectional datasets, with few exceptions (lower agreement between the non-laboratory-based and Framingham (1991) CHD risk scores). Approximately 18% of adults in the DHS population were characterized as ‘high CVD risk’ (10-year CVD death risk >20%) using the non-laboratory-based score. Conclusions We found a high level of correlation between a simple, non-laboratory-based CVD risk score and commonly-used laboratory-based risk scores. The burden of CVD mortality risk was high for men and women in South Africa. The policy and clinical implications are that fast, low-cost screening tools can lead to similar risk assessment results compared to time- and resource-intensive approaches. Until setting-specific cohort studies can derive and validate country-specific risk scores, non-laboratory-based CVD risk assessment could be an effective and efficient primary CVD screening approach in South Africa.en_US
dc.format.extent23 pen_US
dc.language.isoenen_US
dc.publisherBioMed Centralen_US
dc.subject.lcshCardiovascular system--Diseases--Risk factorsen_US
dc.subject.lcshCardiovascular system--Diseases--Preventionen_US
dc.subject.lcshCholesterolen_US
dc.subject.lcshCerebrovascular diseaseen_US
dc.subject.lcshCoronary heart diseaseen_US
dc.titleComparative assessment of absolute cardiovascular disease risk characterization from non-laboratory- based risk assessment in South African populationsen_US
dc.typeArticleen_US
dc.publisher.urihttp://dx.doi.org/10.1186/1741-7015-11-170en_US
dc.dut-rims.pubnumDUT-002876en_US
dc.identifier.doi10.1186/1741-7015-11-170-
item.grantfulltextopen-
item.cerifentitytypePublications-
item.fulltextWith Fulltext-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.openairetypeArticle-
item.languageiso639-1en-
Appears in Collections:Research Publications (Health Sciences)
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