New research led by Kim van Daalen looks at the importance of ensuring risk scores for cardiovascular disease match local needs
The incidence of cardiovascular disease (CVD) – the number one cause of death globally – can be reduced significantly by understanding the risk faced by different populations better, according to a new study.
Identifying individuals at high risk and intervening to reduce risk before an event occurs underpins the majority of national and international primary prevention guidelines.
Cardiovascular diseases were responsible for an estimated 19·8 million deaths in 2022, of which most occurred in low-income and middle-income countries. That makes the accurate assessment of individuals’ risk more crucial than ever.
Yet, CVD risk for individuals can currently be overestimated or underestimated in certain populations depending on the risk score applied, resulting in sub-optimal primary prevention, says the new study, published in Lancet Global Health last night. The study emphasises the need for healthcare providers to consider the specific characteristics of their target population when choosing a cardiovascular disease risk score for primary prevention. By selecting an appropriate risk score, clinicians can improve the accuracy of risk assessments and ensure better-informed decisions, ultimately enhancing outcomes in the prevention of cardiovascular diseases.
The review and framework development, led by Gates Cambridge Scholar Dr Kim van Daalen, and based on her PhD at the University of Cambridge, looks at the large number of cardiovascular risk scores around the world.
While it focuses predominantly on cardiovascular disease risk scores used in general populations for primary prevention across different geographical settings, it acknowledges that there are several population-specific or patient-specific risk scores, although the latter have predominantly been developed in Europe. They include SCORE-OP which estimates cardiovascular disease risk in people aged 65–79 years. Other risk scores include those that measure risk in people with type 2 diabetes or for those with a history of a particular form of heart failure.
The publication says that the variation of risk scores across countries and regions and in risk predictors and methodology mean risk should be assessed based on the local population and its needs and should be regularly reviewed.
It provides an up-to-date overview of guideline-recommended CVD risk scores from various global, regional and national contexts. It evaluates their comparative characteristics and qualities, offering a valuable framework for clinicians in selecting the most appropriate risk score for their target population.
Dr van Daalen [2018] did her PhD in Public Health and Primary Care (Environmental Epidemiology) which focused on environmental risk factors for cardiovascular diseases, with a particular focus on South Asia.
*Picture credit: 3D human heart and circulatory system illustration by Bryan Brandenburg, courtesy of Wikimedia Commons.
