Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles

Ndindjock, Roger; Gédéon, Jude; Mendis, Shanthi; Paccaud, Fred; Bovet, Pascal

doi:10.2471/blt.10.082370

Cited by 47 publications

(48 citation statements)

References 39 publications

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“…CVD generally results from the interplay of a wide range of genetic, socio-economic, individual, physician-related, environmental factors, and healthcare delivery system-related factors (2,3,(5)(6)(7)(8)(9)(10)(11)(12). These risk factors have been targeted in separate high-risk groups and in community settings and encouraging results have been obtained (13,14). In view of the interplay of multiple factors in the etiology of CVDs, it will be wrong to adopt a single risk factor for predicting cardiovascular risk (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)15).…”

Section: Key Messagesmentioning

confidence: 99%

“…We have adopted WHO/ISH cardiovascular risk prediction charts in the current study and not the General Framingham Risk Profile (GFRP) because of the augmentation of risk in wide group of population (20,21). The WHO/ISH charts are designed to aid the clinicians in implementing timely preventive measures to improve the life expectancy, quality of life of the risk groups and reduction in the burdening of the health system (4,13,19). The present study was conducted to assess the prevalence of CVS risk parameters and to estimate the cardiovascular risk among adults aged >40 years, using the WHO/ISH risk charts alone, and with the addition of other parameters.…”

Section: Key Messagesmentioning

confidence: 99%

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Estimation of the cardiovascular risk using World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts in a rural population of South India

Ghorpade

Shrivastava

Kar

et al. 2015

Int J Health Policy Manag

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Background: World Health Organization/International Society of Hypertension (WHO/ISH) charts have been employed to predict the risk of cardiovascular outcome in heterogeneous settings. The aim of this research is to assess the prevalence of Cardiovascular Disease (CVD) risk factors and to estimate the cardiovascular risk among adults aged >40 years, utilizing the risk charts alone, and by the addition of other parameters. Methods: A cross-sectional study was performed in two of the villages availing health services of a medical college. Overall 570 subjects completed the assessment. The desired information was obtained using a pretested questionnaire and participants were also subjected to anthropometric measurements and laboratory investigations. The WHO/ISH risk prediction charts for the South-East Asian region was used to assess the cardiovascular risk among the study participants. Results: The study covered 570 adults aged above 40 years. The mean age of the subjects was 54.2 (±11.1) years and 53.3% subjects were women. Seventeen percent of the participants had moderate to high risk for the occurrence of cardiovascular events by using WHO/ISH risk prediction charts. In addition, CVD risk factors like smoking, alcohol, low High-Density Lipoprotein (HDL) cholesterol were found in 32%, 53%, 56.3%, and 61.5% study participants, respectively. Conclusion: Categorizing people as low (<10%)/moderate (10%-20%)/high (>20%) risk is one of the crucial steps to mitigate the magnitude of cardiovascular fatal/non-fatal outcome. This cross-sectional study indicates that there is a high burden of CVD risk in the rural Pondicherry as assessed by WHO/ISH risk prediction charts. Use of WHO/ISH charts is easy and inexpensive screening tool in predicting the cardiovascular event.

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Section: Key Messagesmentioning

confidence: 99%

Section: Key Messagesmentioning

confidence: 99%

Estimation of the cardiovascular risk using World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts in a rural population of South India

Ghorpade

Shrivastava

Kar

et al. 2015

Int J Health Policy Manag

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“…Not only that, high profile professors as shapers of medical practice sometimes promote particular interventions in media events organized by market authorization holders even where no supporting evidence exists. This can confer legitimacy on dubious therapeutics claims [94,95]. Apart from fuelling inappropriate use of medicines, this can also promote the notion that other people's treatment priorities should be adopted everywhere without prior determination whether or not such therapies are equally beneficial to local population.…”

Section: Resultsmentioning

confidence: 99%

Aspirin and Diabetes Care in Nigeria: Treatment or Exploitation?

Eo¹,

Oyejola²

2015

J Clinic Res Bioeth

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Cardiovascular disorders have become leading drivers of untimely deaths almost everywhere. Such deaths are however declining globally due to effective interventions. Low dose aspirin contributes to this reduction when used appropriately through minimization of the risk of coronary heart disease and other occlusive atherosclerotic syndromes that can complicate type 2 diabetes/or hypertension. One local study published in 2004 indicated that aspirin was prescribed for 33% of patients with type 2 diabetes. Since then, aspirin prescription, as part of standard therapy for type 2 diabetes/or hypertension, has risen steadily with some studies reporting this to be 66%-88%; These figures more than double those reported in jurisdictions overseas where occlusive atherosclerotic disorders commonly complicate type 2 diabetes and/or hypertension. Even so, recent transnational data show that cardiovascular deaths linked to type 2 diabetes and or hypertension are not abating in sub-Saharan Africa as in many other regions. This can suggest that interventions in black Africa, if any, maybe less than effective in comparison to areas where health outcomes are improving. Significantly, type 2 diabetes and/or hypertension can behave differently in many black groups within Africa such that occlusive atherosclerotic disorders are less common health consequences even with rising cholesterol levels. In the case of Nigeria, the evidence of cardiovascular health benefits of aspirin, as extensively described in groups overseas, appears hard to find for local cohorts. Indeed what the available data strongly suggest is that effective control of blood pressure is a higher treatment priority for saving Nigerian lives than interventions aimed at retarding the atherosclerotic process. Given these observations, the question ought to be asked whether or not low dose aspirin in type 2 diabetes/hypertension therapies, as locally practiced, is the best way of optimizing limited resources in saving Nigerian lives. This paper examines the evidence.

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“…In addition, primary prevention informed by multifactorial CVD risk assessment is likely to prevent a similar number of cardiovascular events at a possibly lower cost than a singlefactor approach [17].…”

Section: Recent Trends In Cardiovascular Risks 58mentioning

confidence: 99%

Cardiovascular Risk Assessment in Developing World

Chamnan¹,

Aekplakorn²

2017

Recent Trends in Cardiovascular Risks

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Many international and national authorities recommend that cardiovascular risk assessment using multivariate risk scores be used to identify individuals at high risk of cardiovascular disease (CVD). This approach is likely to assure that resources in developing countries are allocated to those who need it most. However, not many developing countries have implemented this approach and different countries have varying progresses in adopting the concept. While many developing countries solely described estimated cardiovascular risk by applying existing CVD risk scores to their population's cross-sectional data, a number of countries have validated and recalibrated existing risk scores and only a few have developed new risk scores specific to their populations. To enhance the adoption of such a policy in developing countries, new CVD risk prediction charts for low-and medium-resource settings were developed and endorsed by the WHO and International Society of Hypertension. However, a number of issues need to be addressed, including development of population-specific risk scores, recalibration of available risk scores and uncertainty over cost-effectiveness of CVD risk assessment in developing countries. Although this high risk approach might represent an effective and practical strategy for developing countries, a complementary population-based approach is also needed to maximize benefits for CVD prevention.

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Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles

Cited by 47 publications

References 39 publications

Estimation of the cardiovascular risk using World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts in a rural population of South India

Estimation of the cardiovascular risk using World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts in a rural population of South India

Aspirin and Diabetes Care in Nigeria: Treatment or Exploitation?

Cardiovascular Risk Assessment in Developing World

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