Riskard 2005. New tools for prediction of cardiovascular disease risk derived from Italian population studies

Menotti, Alessandro; Lanti, Mariapaola; Agabiti‐Rosei, Enrico; Carratelli, L.; Cavera, G.; Dormi, Ada; Gaddi, Antonio Vittorino; Mancini, Mario; Motolese, M; Muiesan, María Lorenza; Muntoni, Sandro; Muntoni, Sergio; Notarbartoló, A; Prati, Pier Luigi; Remiddi, Stefano; Zanchetti, Alberto

doi:10.1016/j.numecd.2005.07.007

Cited by 50 publications

(19 citation statements)

References 14 publications

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“…The Framingham and other similar studies (e.g. PROCAM [Munster], 15 Seven Countries Study, SCORE 16 and Progetto CUORE 17 studies) provide the basis for the equations upon which many of the existing cardiovascular risk-profiling packages 11,[18][19][20][21][22][23][24][25][26][27][28] have been developed. 29 However, such risk profiling protocols lack universal applicability 11,13,14,[29][30][31][32][33][34][35][36][37][38][39][40][41][42] and may be of limited applicability in developing countries, whose populations were not sampled for the Framingham 31,32 and other studies.…”

Section: Introductionmentioning

confidence: 99%

Can non-physician health-care workers assess and manage cardiovascular risk in primary care?

Abegunde

Shengelia

Luyten

et al. 2007

Bull World Health Organ

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Objective To ascertain the reliability of applying the WHO Cardiovascular Risk Management Package by non-physician health-care workers (NPHWs) in typical primary health-care settings. Methods Based on an a priori 80% agreement level between the NPHWs and the "expert" physicians (gold standard), 649 paired (matched) applications of the protocol were obtained for analysis using Kappa statistic and multivariate logit regression. Findings Results indicate over 80% agreement between raters, from moderate to perfect levels of agreement in almost all of the sections in the package. The odds of obtaining a difference between raters and a benchmark are not statistically significant. Conclusion Applying the WHO Cardiovascular Risk Management Package, NPHWs can be retrained to reliably and effectively assess and manage cardiovascular risks in primary health-care settings where there are no attending physicians. The package could be a useful tool for scaling up the management of cardiovascular diseases in primary health care. IntroductionChronic noncommunicable diseases, especially cardiovascular diseases, are a major and increasing cause of death and disability worldwide, and may have retarding effects on the economies of affected individuals, households and countries. 1,2 The epidemiological and economic effects of cardiovascular diseases (specifically stroke and heart diseases) and diabetes, are especially pervasive in low-and middle-income countries 1-3 where health systems are less likely to adequately respond to the challenges of the increasing burden. Socioeconomic barriers and inequalities in access to treatment, suboptimal staffing of health-care facilities and limited capacity for ancillary investigations that complement cardiovascular risk profiling are some of the common problems limiting these countries' control of chronic diseases, especially at the primary healthcare level. 4 This situation is worsened by the brain-drain syndrome 5-9 resulting in shortages of skilled workers.Can non-physician health-care workers assess and manage cardiovascular risk in primary care? 29 However, such risk profiling protocols lack universal applicability 11,13,14,[29][30][31][32][33][34][35][36][37][38][39][40][41][42] and may be of limited applicability in developing countries, whose populations were not sampled for the Framingham 31,32 and other studies. Uncritical adoption of such protocols may result in negative clinical and economic consequences. 43 To address the absence of a CVD risk profiling tool for developing countries, WHO in 2000 developed a package for the assessment and management of cardiovascular risk in low-resource settings. 44 The package, developed through consultations with experts from all WHO regions, was designed as an adaptable, cost-effective tool for systematic case management at all health-care levels, and consequently for scaling up countries' health systems. The expert panel based the design of the package on the graded evidence available.The package includes three scenarios that reflect commonl...

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Section: Introductionmentioning

confidence: 99%

Can non-physician health-care workers assess and manage cardiovascular risk in primary care?

Abegunde

Shengelia

Luyten

et al. 2007

Bull World Health Organ

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show abstract

“…40; absolute values 82.61 ± 12.13 ng/ml vs. IGF1SDS 0.39±1.07; absolute values 156.76 ± 16.04 ng/ml, respectively. P IGF1SDS= 0.002; P IGF1 absolute values= 0.002).…”

Section: Resultsmentioning

confidence: 89%

“…Cardiovascular risk charts have been elaborated from these mathematical functions, considering major cardiovascular risk factors: sex, age, blood pressure, total and HDL cholesterol levels and cigarette smoking. 40 This chart (Risk Card 2009) offers the option of evaluating both protective factors (as for instance HDL cholesterol levels) and risk factors in the cardiovascular risk assessment. 41 …”

Section: Coronary Riskmentioning

confidence: 99%

Autonomic nervous system and cardiovascular risk assessment during one year of growth hormone (GH) replacement therapy in adults with GH deficiency

Boschetti¹,

Casu²,

Moretti³

et al. 2014

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oBJecTIve: This prospective study aimed to evaluate the impact of growth hormone deficiency (gHd) on cardiac autonomic tone and on cardiovascular risk and the changes after 12 months of gH replacement therapy (gHrT). gHd is associated with increased cardiovascular morbidity and mortality. This has been attributed to increased markers of cardiovascular risk and to abnormalities of both the cardiac and peripheral autonomic nervous systems. The autonomic cardiac nervous system (AcNs) can be indirectly evaluated by analysis of heart rate variability (Hrv) in clinostatism and orthostatism. desIgN: We compared 14 gHd patients at baseline and after 12 months of gHrT and 17 healthy controls. We analyzed a number of cardiovascular risk factors and we used analysis of Hrv during the Tilt Test that identified high frequency (HF) and low frequency (lF), representing parasympathetic and sympathetic activity, respectively. resUlTs: compared with the control group, in either clinostatism or in orthostatism our patients showed a significantly lower value of lF (P=0.047; P=0.004, respectively), whereas HF was significantly reduced in orthostatism (P=0.037), and indicatively in clinostatism (P=0.065). These values remained unchanged after 12 months of gHrT. No statistically significant differences were found between the lF/HF ratio in untreated and treated patients. In gHd patients, there was a significant reduction of cardiovascular risk in 12 months of replacement therapy (P=0.002). coNclUsIoNs: our study highlights the absence of sympathovagal imbalance in gHd patients; gHrT does not change AcNs during the first year of gH treatment but it reduces the absolute cardiovascular risk in these patients.

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“…The Riskard was published in 2005 (20) as multiple genderspecific equations for the software Riskard 2005 to assess the risk of a coronary event, the risk of a cerebrovascular event and the risk of a total cardiovascular event, each within 5, 10 and 15 years, as well as an equation underlying the risk charts Riskard 2005 for a cardiovascular event within 10 years. The software algorithms were derived from data of almost 16,000 persons aged 35-74 years.…”

Section: Riskardmentioning

confidence: 99%

Overview of Risk-Estimation Tools for Primary Prevention of Cardiovascular Diseases in European Populations

Gorenoi¹,

Hagen²

2015

Cent Eur J Public Health

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SUMMARYTo identify persons with a high risk for cardiovascular diseases (CVD) special tools (scores, charts, graphics or computer programs) for CVD-risk assessment based on levels of the certain risk factors have been constructed. The applicability of these instruments depends on the derivation cohorts, considered risk factors and endpoints, applied statistical methods as well as used formats.The review addresses the risk-estimation tools for primary prevention of CVD potentially relevant for European populations. The risk-estimation tools were identified using two previously published systematic reviews as well as conducting a literature search in MEDLINE and a manual search. Only instruments were considered which were derived from cohorts of at least 1,000 participants of one gender without pre-existing CVD, enable risk assessment for a period of at least 5 years, were designed for an age-range of at least 25 years and published after the year 2000.A number of risk-estimation tools for CVD derived from single European, several European and from non-European cohorts were identified. From a clinical perspective, seem to be preferable instruments for risk of CVD contemporary developed for the population of interest, which use easily accessible measures and show a high discriminating ability. Instruments, restricting risk-estimation to certain cardiovascular events, recalibrated high-accuracy tools or tools derived from European populations with similar risk factors distribution and CVD-incidence are the second choice. In younger people, calculating the relative risk or cardiovascular age equivalence measures may be of more benefit.

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Riskard 2005. New tools for prediction of cardiovascular disease risk derived from Italian population studies

Cited by 50 publications

References 14 publications

Can non-physician health-care workers assess and manage cardiovascular risk in primary care?

Can non-physician health-care workers assess and manage cardiovascular risk in primary care?

Autonomic nervous system and cardiovascular risk assessment during one year of growth hormone (GH) replacement therapy in adults with GH deficiency

Overview of Risk-Estimation Tools for Primary Prevention of Cardiovascular Diseases in European Populations

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