Title:Cardiovascular Risk Calculators and their Applicability to South Asians
Volume: 17
Issue: 9
Author(s): Manish Bansal*, Shraddha Ranjan and Ravi R. Kasliwal
Affiliation:
- Clinical and Preventive Cardiology, Medanta- The Medicity, Gurgaon, Haryana,India
Keywords:
Atherosclerotic cardiovascular disease, primary prevention, secondary prevention, cardiovascular risk, lifetime
risk, subclinical atherosclerosis.
Abstract:
Background: Estimation of absolute cardiovascular disease (CVD) risk and tailoring
therapies according to the estimated risk is a fundamental concept in the primary prevention of
CVD is assessed in this study. Numerous CVD risk scores are currently available for use in various
populations but unfortunately, none exist for South Asians who have much higher CVD risk as
compared to their western counterparts.
Methods: A literature search was done using PubMed and Google search engines to prepare a narrative
review on this topic.
Results: Various currently available CVD risk scores and their pros and cons are summarized. The
studies performed in native as well as migrant South Asians evaluating the accuracy of these risk
scores for estimation of CVD risk are also summarized. The findings of these studies have generally
been inconsistent, but it appears that the British risk scores (e.g. QRISK versions) may be more
accurate because of inclusion of migrant South Asians in the derivation of these risk scores. However,
the lack of any prospective study precludes our ability to draw any firm conclusions. Finally,
the potential solution to these challenges, including the role of recalibration and subclinical atherosclerosis
imaging, is also discussed.
Conclusion: This review highlights the need to develop large, representative, prospectively followed
databases of South Asians providing information on various CVD risk factors and their contribution
to incident CVD. Such databases will not only allow the development of validated CVD
risk scores for South Asians but will also enable application of machine-learning approaches to provide
personalized solutions to CVD risk assessment and management in these populations.
