Predicted 10-year risk of cardiovascular mortality in the 40 to 69 year old general population without cardiovascular diseases in Germany

Diederichs, Claudia; Neuhauser, Hannelore; Rücker, Viktoria; Busch, Markus; Keil, Ulrich; Fitzgerald, Anthony P.; Heuschmann, Peter U.

doi:10.1371/journal.pone.0190441

Cited by 19 publications

(17 citation statements)

References 27 publications

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“…In Uganda, a large HIV positive cohort population study, showed that men were at high 10-year risk of acute CVD and ART treated populations were more at risk of longer term CVD, as suggested in our study [25]. Of our study patients, 8% were shown to be at greater than a 30% 10-year risk of CVD mortality, similar to what was reported among a general population (5.7% and above) with a comparable age range in Germany and India [50, 51]. We have shown that there is a linear association between older age, patients who have been on ART for longer, and are in the high-risk score band (7.96 ± 4.38 years) compared to very low risk (6.51 ± 3.47 years) for CVD mortality.…”

Section: Discussionsupporting

confidence: 87%

Association of predicted 10 years cardiovascular mortality risk with duration of HIV infection and antiretroviral therapy among HIV-infected individuals in Durban, South Africa

Todowede

Sartorius

Magula

et al. 2019

Diabetol Metab Syndr

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BackgroundSouth Africa has the largest population of human immunodeficiency virus (HIV) infected patients on antiretroviral therapy (ART) realising the benefits of increased life expectancy. However, this population may be susceptible to cardiovascular disease (CVD) development, due to the chronic consequences of a lifestyle-related combination of risk factors, HIV infection and ART. We predicted a 10-year cardiovascular mortality risk in an HIV-infected population on long-term ART, based on their observed metabolic risk factor profile.MethodsWe extracted data from hospital medical charts for 384 randomly selected HIV-infected patients aged ≥ 30 years. We defined metabolic syndrome (MetS) subcomponents using the International Diabetes Federation definition. A validated non-laboratory-based model for predicting a 10-year CVD mortality risk was applied and categorised into five levels, with the thresholds ranging from very low-risk (< 5%) to very high-risk scores (> 30%).ResultsAmong the 384 patients, with a mean (± standard deviation) age of 42.90 ± 8.20 years, the proportion of patients that were overweight/obese was 53.3%, where 50.9% had low high-density lipoprotein (HDL) cholesterol and 21 (17.5%) had metabolic syndrome. A total of 144 patients with complete data allowed a definitive prediction of a 10-year CVD mortality risk. 52% (95% CI 44–60) of the patients were stratified to very low risk (< 5%) compared to 8% (95% CI 4–13) that were at a very high risk (> 30%) of 10-year CVD mortality. The CVD risk grows with increasing age (years), 57.82 ± 6.27 among very high risk and 37.52 ± 4.50; p < 0.001 in very low risk patients. Adjusting for age and analysing CVD risk mortality as a continuous risk score, increasing duration of HIV infection (p = 0.002) and ART (p = 0.007) were significantly associated with increased predicted 10 year CVD mortality risk. However, there was no association between these factors and categorised CVD mortality risk as per recommended scoring thresholds.ConclusionsApproximately 1 in 10 HIV-infected patients is at very high risk of predicted 10-year CVD mortality in our study population. Like uninfected individuals, our study found increased age as a major predictor of 10-year mortality risk and high prevalence of metabolic syndrome. Additional CVD mortality risk due to the duration of HIV infection and ART was seen in our population, further studies in larger and more representative study samples are encouraged. It recommends an urgent need for early planning, prevention and management of metabolic risk factors in HIV populations, at the point of ART initiation.

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Section: Discussionsupporting

confidence: 87%

Association of predicted 10 years cardiovascular mortality risk with duration of HIV infection and antiretroviral therapy among HIV-infected individuals in Durban, South Africa

Todowede

Sartorius

Magula

et al. 2019

Diabetol Metab Syndr

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“…However, all procedures conducted in both groups were identical, and they were treated separately only in analysis. The age of 40 was chosen in order to divide the study sample into younger and older ones, as in a number of studies of cardiovascular risk, the participants aged above 40 are treated as a separate group, as they may develop cardiovascular problems even if not diagnosed [ 12 , 13 ]. Similarly, for the Framingham Heart Study cohort, the age group of participants older than 40 was also analyzed [ 14 ] and some authors even recommend to conduct the formal cardiovascular disease risk assessment, in the case of no risk factors, only for patients at the age of 40 or more [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Intake of Saturated Fatty Acids Affects Atherogenic Blood Properties in Young, Caucasian, Overweight Women Even without Influencing Blood Cholesterol

Hamułka

Głąbska

Guzek

et al. 2018

IJERPH

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Despite a general relation between fat intake and cardiovascular risk factors, the association is often not observed in studies conducted in heterogenic populations, as for population groups, it may differ. The aim of the study was to analyze the associations between dietary fat intake and lipoprotein cholesterol fractions, as well as atherogenic blood properties, in young and middle-aged overweight Caucasian women. In a group of 138 overweight women, the three-day dietary records were assessed, under-reporters were excluded, and lipoprotein cholesterol fractions were analyzed. For the included 24 young (aged 20–40) and 42 middle-age women (aged 40–60), the intakes of fat, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), and cholesterol, as well as the PUFA/SFA ratio, were assessed. Afterwards, the analysis of associations with blood levels of total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride, as well as the TC/HDL ratio, HDL/LDL, ratio and Atherogenic Index of Plasma (AIP), were conducted. It was stated that the influence of the dietary fat level on lipoprotein cholesterol fractions as well as atherogenic blood properties in overweight Caucasian women is age dependent. For young, overweight, Caucasian women, the influence of the dietary fat level on the lipoprotein cholesterol fractions was not observed; however, SFA intake influenced atherogenic blood properties. For middle-aged, overweight, Caucasian women, the PUFA intake had an especially important influence in increasing the HDL cholesterol level. For overweight Caucasian women, not only should lipoprotein cholesterol fractions be controlled, but also the AIP calculated—especially for younger women.

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“…26 In Germany, similar results were observed for women but not for men. 27 However, differences in indicators used do assess socioeconomic status do not allow direct comparisons of estimates to be made with our study because they used composite socioeconomic status indicators.…”

Section: Discussionmentioning

confidence: 95%

Estimation of the 10-Year Risk of Fatal Cardiovascular Disease in the Portuguese Population: Results from the First Portuguese Health Examination Survey (INSEF 2015)

Gaio¹,

Rodrigues²,

Kislaya³

et al. 2020

Acta Med Port

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Introduction: Cardiovascular disease is the leading cause of morbidity and mortality in Portugal and globally. Cardiovascular risk algorithms, namely the SCORE (Systematic Coronary Risk Evaluation), are recommended in the context of cardiovascular disease prevention. Our aim is to estimate and characterize the cardiovascular risk of the Portuguese population aged between 40 and 65 years old, in 2015, using the SCORE algorithm.Material and Methods: This study was performed on a subsample of the first Portuguese National Health Examination Survey - INSEF, including all participants between 40 and 65 years old with available data on sex, age, smoking status, total cholesterol and systolic blood pressure (n = 2945). The prevalence of the cardiovascular risk categories were stratified by sex, age group, marital status, educational level, occupational activity, urbanization of living area, region and income.Results: In 2015, about 5.1% and 11.9% of the Portuguese resident population aged between 40 and 65 years old were, respectively, at high and very high risk of having a fatal CV event in the following 10 years. The highest prevalence of very high cardiovascular risk was found in males, individuals aged 60-65 years old, married or living with someone, without any formal education or just with the 1st cycle of basic education and belonging to the less skilled category of the occupational activity (C category) in comparison with the othercorresponding groups.Discussion: A previous national study found a similar proportion of the population at high/very high cardiovascular risk (19.5% versus 17.1%). Our study is representative of the adult Portuguese population and adopted the European Health Examination Survey procedures, which are essential for future comparisons with other European countries. Some of the limitations of this study include the possible participation bias and the non-calibration of the SCORE algorithm for the Portuguese population.Conclusion: In 2015, a considerable proportion of the Portuguese population aged between 40 and 65 years old had a high or very high risk of developing a fatal cardiovascular event in the next 10 years. Due to the possible overestimation of the cardiovascular risk already reported in other European countries, it will be important to carry out a follow-up study to validate the adequacy of using the SCORE algorithm in the Portuguese population.

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Predicted 10-year risk of cardiovascular mortality in the 40 to 69 year old general population without cardiovascular diseases in Germany

Cited by 19 publications

References 27 publications

Association of predicted 10 years cardiovascular mortality risk with duration of HIV infection and antiretroviral therapy among HIV-infected individuals in Durban, South Africa

Association of predicted 10 years cardiovascular mortality risk with duration of HIV infection and antiretroviral therapy among HIV-infected individuals in Durban, South Africa

Intake of Saturated Fatty Acids Affects Atherogenic Blood Properties in Young, Caucasian, Overweight Women Even without Influencing Blood Cholesterol

Estimation of the 10-Year Risk of Fatal Cardiovascular Disease in the Portuguese Population: Results from the First Portuguese Health Examination Survey (INSEF 2015)

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