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Comparative Study
. 2015 Aug 7;4(8):e002112.
doi: 10.1161/JAHA.115.002112.

Distribution of Short-Term and Lifetime Predicted Risks of Cardiovascular Diseases in Peruvian Adults

Renato Quispe  1 , Juan Carlos Bazo-Alvarez  1 , Melissa S Burroughs Peña  2 , Julio A Poterico  1 , Robert H Gilman  3 , William Checkley  4 , Antonio Bernabé-Ortiz  1 , Mark D Huffman  5 , J Jaime Miranda  6 ; PERU MIGRANT Study; CRONICAS Cohort Study Group
Collaborators, Affiliations
Comparative Study

Distribution of Short-Term and Lifetime Predicted Risks of Cardiovascular Diseases in Peruvian Adults

Renato Quispe et al. J Am Heart Assoc. .

Abstract

Background: Short-term risk assessment tools for prediction of cardiovascular disease events are widely recommended in clinical practice and are used largely for single time-point estimations; however, persons with low predicted short-term risk may have higher risks across longer time horizons.

Methods and results: We estimated short-term and lifetime cardiovascular disease risk in a pooled population from 2 studies of Peruvian populations. Short-term risk was estimated using the atherosclerotic cardiovascular disease Pooled Cohort Risk Equations. Lifetime risk was evaluated using the algorithm derived from the Framingham Heart Study cohort. Using previously published thresholds, participants were classified into 3 categories: low short-term and low lifetime risk, low short-term and high lifetime risk, and high short-term predicted risk. We also compared the distribution of these risk profiles across educational level, wealth index, and place of residence. We included 2844 participants (50% men, mean age 55.9 years [SD 10.2 years]) in the analysis. Approximately 1 of every 3 participants (34% [95% CI 33 to 36]) had a high short-term estimated cardiovascular disease risk. Among those with a low short-term predicted risk, more than half (54% [95% CI 52 to 56]) had a high lifetime predicted risk. Short-term and lifetime predicted risks were higher for participants with lower versus higher wealth indexes and educational levels and for those living in urban versus rural areas (P<0.01). These results were consistent by sex.

Conclusions: These findings highlight potential shortcomings of using short-term risk tools for primary prevention strategies because a substantial proportion of Peruvian adults were classified as low short-term risk but high lifetime risk. Vulnerable adults, such as those from low socioeconomic status and those living in urban areas, may need greater attention regarding cardiovascular preventive strategies.

Keywords: Pooled Cohort Risk Equations; cardiovascular risk; lifetime cardiovascular risk; risk estimation tools; short‐term cardiovascular risk.

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Figures

Figure 1
Figure 1
Distribution of risk in CRONICAS and PERU MIGRANT studies. A, Short-term and lifetime risk. B, Risk strata. For both panels, distribution was significantly different by sex (P<0.001).
See this image and copyright information in PMC

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