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

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Publisher: Kerman University of Medical Sciences
Document Type: Report
Length: 4,644 words
Lexile Measure: 1420L

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Background

For many years, diseases of infectious origin are the leading cause accounting for mortality, especially in resource-constraint settings (1). However, in the past few decades owing to urbanization/globalization, increased life expectancy, and adoption of harmful lifestyles, Non-Communicable Diseases (NCDs), especially Cardiovascular Disease (CVD) has emerged as one of the leading cause of morbidity, early death, overburdening of the public health infrastructure, and escalating direct/indirect healthcare costs throughout the world (2-4).

CVD results secondary to the abnormalities in the cardiovascular system, and includes a wide spectrum of disorders (5). Despite the reduction in the incidence of Coronary Heart Disease (CHD) in developed nations, the scenario in developing nations poses a serious challenge (6). 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 (2,3,5-12). 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 (2-11,15). In fact, the best approach will be to adopt a particular risk chart which considers a maximum number of all probable determinants so that the contribution of each of the risk factors can be ascertained in different regions (15-17). The total risk approach was initially implemented in the developed nations and subsequently they have been employed in other parts of the world after adjustments (16-18). The World Health Organization (WHO) and the International Society of Hypertension (ISH) have formulated CVS risk prediction charts for use in different sections of the globe using the best available mortality and risk factor data (15,19). The proposed chart is a cost-effective tool to stratify the entire population using a risk score and thus presents a ten-year risk of major cardiovascular outcome in 14 of the WHO epidemiological sub-regions. Hence, it is a useful tool to counsel patients to modify their lifestyles or comply with their medicines (19). 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.

Methods

A cross-sectional study was performed from November 2011 to January 2012. As per the report of the Census 2011, the Union territory of Pondicherry has a total population of 1.25 million (22).

Study population

Of the three villages under the rural health centre, two villages --Ramanathapuram (population 2,165) and Pillaiyarkuppam (population 2,412) were chosen purposively for...

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Source Citation   

Gale Document Number: GALE|A427493949