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New score predicts cardiovascular risk for ‘anyone in world’ over 40

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Researchers have developed a new risk score which they claim can predict the 10-year risk of developing heart disease or having a stroke in patients aged 40 years or older in any country.

The new score, called Globorisk, is based on data from eight cohort studies, including more than 50,000 participants.

Among them is the seminal Framingham Heart Study, on which previous CVD risk scores for Western countries have largely been based.

However, unlike previous risk scores, the developers of Globorisk said it could be updated to fit local conditions and risk factor levels in different countries using routinely available information.

“Globorisk is an important advance in the field of global cardiovascular disease prevention”

Goodarz Danaei

Globorisk measures CVD risk in individuals aged 40 or older by factoring in smoking status, blood pressure, diabetes status, and total cholesterol level – while adjusting for the effects of sex and age on CVD between countries.

The researchers recalibrated and applied their risk score to 11 countries using data from national health surveys to replace the average age-and-sex risk factor levels in each country and incorporating CVD death rates for each age-and-sex group.

They then developed country-specific risk charts for predicting individuals’ risk of CVD, and country-specific assessments of the 10-year CVD burden.

The researchers estimate that the proportion of people at high risk – 10% or higher – of having a fatal heart attack or stroke within 10 years is higher in low- and middle-income countries, compared with high-income countries.

For example, in China around a third of men and women have a high 10-year risk of dying from a CVD event compared with only 5-10% of men and women in Spain and Denmark.

The study, published in The Lancet Diabetes and Endocrinology, was led by Dr Goodarz Danaei, assistant professor of global health at the Harvard T. H. Chan School of Public Health in Boston. 

He described Globorisk as “an important advance” in global CVD prevention.

“Until now, most prediction scores were developed using a single cohort study and were never validated for accuracy in national populations for low- and middle-income countries,” he said.

“Globorisk can be used to identify individuals at high risk of developing CVD who are most likely to benefit from lifestyle changes or preventive drug treatment,” he added.

The study was funded by the Medical Research Council, the Wellcome Trust and the US National Institutes of Health.

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