Application of two versions of the WHO/international society of hypertension absolute cardiovascular risk assessment tools in a rural Bangladeshi population

Kaniz Fatema, Nicholas Arnold Zwar, Abul Hasnat Milton, Bayzidur Rahman, Liaquat Ali

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4 Citations (Scopus)

Abstract

Objectives: To estimate the absolute cardiovascular disease (CVD) risk burden in a remote rural Bangladeshi population using the 'With' and 'Without' Cholesterol versions of the WHO/International Society of Hypertension (WHO/ISH) CVD risk assessment chart (particularly suitable for low and middle-income countries due to less reliance on laboratory testing) and to evaluate the agreement between the two approaches. Design: Cross-sectional study using data from a large prospective cohort of the North Bengal Non-Communicable Disease Programme (NB-NCDP) of Bangladesh. Setting: General rural population from Thakurgaon district of Bangladesh. Participants: 563 individuals who were categorised as having 'no CVDs' on screening by a questionnairebased survey using the 'WHO CVD-Risk Management Package' developed in 2002. Main outcome measures: Absolute CVD risk burden assessed using two versions of the WHO/ISH risk assessment charts for the South-East Asian Region-D. Results: 10-year risk (moderate, high and very high) positivity was present among 21.5% and 20.2% of participants, respectively, using with and without cholesterol versions of the tool. The overall concordance rate for the two versions was 89.5% and they did not differ significantly in estimating the proportion of overall participants having higher levels of CVD. The projected drug requirement, however, showed a significant overestimation in the proportion of participants at both the threshold levels (p0.002) on using 'without' as compared to 'with' cholesterol versions. Conclusions: About one-fifth of the adult population in Bangladesh, even in a remote rural area, seem to be at risk of developing CVDs (25% of them at high risk and 25% at very high risk) within 10 years with males and females being almost equally vulnerable.

Original languageEnglish
Article numbere008140
JournalBMJ Open
Volume5
Issue number10
DOIs
Publication statusPublished - 1 Jan 2015
Externally publishedYes

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Rural Population
Hypertension
Cardiovascular Diseases
Bangladesh
Cholesterol
Risk Management
Disease Management
Cross-Sectional Studies
Outcome Assessment (Health Care)
Pharmaceutical Preparations
Population

Cite this

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title = "Application of two versions of the WHO/international society of hypertension absolute cardiovascular risk assessment tools in a rural Bangladeshi population",
abstract = "Objectives: To estimate the absolute cardiovascular disease (CVD) risk burden in a remote rural Bangladeshi population using the 'With' and 'Without' Cholesterol versions of the WHO/International Society of Hypertension (WHO/ISH) CVD risk assessment chart (particularly suitable for low and middle-income countries due to less reliance on laboratory testing) and to evaluate the agreement between the two approaches. Design: Cross-sectional study using data from a large prospective cohort of the North Bengal Non-Communicable Disease Programme (NB-NCDP) of Bangladesh. Setting: General rural population from Thakurgaon district of Bangladesh. Participants: 563 individuals who were categorised as having 'no CVDs' on screening by a questionnairebased survey using the 'WHO CVD-Risk Management Package' developed in 2002. Main outcome measures: Absolute CVD risk burden assessed using two versions of the WHO/ISH risk assessment charts for the South-East Asian Region-D. Results: 10-year risk (moderate, high and very high) positivity was present among 21.5{\%} and 20.2{\%} of participants, respectively, using with and without cholesterol versions of the tool. The overall concordance rate for the two versions was 89.5{\%} and they did not differ significantly in estimating the proportion of overall participants having higher levels of CVD. The projected drug requirement, however, showed a significant overestimation in the proportion of participants at both the threshold levels (p0.002) on using 'without' as compared to 'with' cholesterol versions. Conclusions: About one-fifth of the adult population in Bangladesh, even in a remote rural area, seem to be at risk of developing CVDs (25{\%} of them at high risk and 25{\%} at very high risk) within 10 years with males and females being almost equally vulnerable.",
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Application of two versions of the WHO/international society of hypertension absolute cardiovascular risk assessment tools in a rural Bangladeshi population. / Fatema, Kaniz; Zwar, Nicholas Arnold; Milton, Abul Hasnat; Rahman, Bayzidur; Ali, Liaquat.

In: BMJ Open, Vol. 5, No. 10, e008140, 01.01.2015.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Application of two versions of the WHO/international society of hypertension absolute cardiovascular risk assessment tools in a rural Bangladeshi population

AU - Fatema, Kaniz

AU - Zwar, Nicholas Arnold

AU - Milton, Abul Hasnat

AU - Rahman, Bayzidur

AU - Ali, Liaquat

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Objectives: To estimate the absolute cardiovascular disease (CVD) risk burden in a remote rural Bangladeshi population using the 'With' and 'Without' Cholesterol versions of the WHO/International Society of Hypertension (WHO/ISH) CVD risk assessment chart (particularly suitable for low and middle-income countries due to less reliance on laboratory testing) and to evaluate the agreement between the two approaches. Design: Cross-sectional study using data from a large prospective cohort of the North Bengal Non-Communicable Disease Programme (NB-NCDP) of Bangladesh. Setting: General rural population from Thakurgaon district of Bangladesh. Participants: 563 individuals who were categorised as having 'no CVDs' on screening by a questionnairebased survey using the 'WHO CVD-Risk Management Package' developed in 2002. Main outcome measures: Absolute CVD risk burden assessed using two versions of the WHO/ISH risk assessment charts for the South-East Asian Region-D. Results: 10-year risk (moderate, high and very high) positivity was present among 21.5% and 20.2% of participants, respectively, using with and without cholesterol versions of the tool. The overall concordance rate for the two versions was 89.5% and they did not differ significantly in estimating the proportion of overall participants having higher levels of CVD. The projected drug requirement, however, showed a significant overestimation in the proportion of participants at both the threshold levels (p0.002) on using 'without' as compared to 'with' cholesterol versions. Conclusions: About one-fifth of the adult population in Bangladesh, even in a remote rural area, seem to be at risk of developing CVDs (25% of them at high risk and 25% at very high risk) within 10 years with males and females being almost equally vulnerable.

AB - Objectives: To estimate the absolute cardiovascular disease (CVD) risk burden in a remote rural Bangladeshi population using the 'With' and 'Without' Cholesterol versions of the WHO/International Society of Hypertension (WHO/ISH) CVD risk assessment chart (particularly suitable for low and middle-income countries due to less reliance on laboratory testing) and to evaluate the agreement between the two approaches. Design: Cross-sectional study using data from a large prospective cohort of the North Bengal Non-Communicable Disease Programme (NB-NCDP) of Bangladesh. Setting: General rural population from Thakurgaon district of Bangladesh. Participants: 563 individuals who were categorised as having 'no CVDs' on screening by a questionnairebased survey using the 'WHO CVD-Risk Management Package' developed in 2002. Main outcome measures: Absolute CVD risk burden assessed using two versions of the WHO/ISH risk assessment charts for the South-East Asian Region-D. Results: 10-year risk (moderate, high and very high) positivity was present among 21.5% and 20.2% of participants, respectively, using with and without cholesterol versions of the tool. The overall concordance rate for the two versions was 89.5% and they did not differ significantly in estimating the proportion of overall participants having higher levels of CVD. The projected drug requirement, however, showed a significant overestimation in the proportion of participants at both the threshold levels (p0.002) on using 'without' as compared to 'with' cholesterol versions. Conclusions: About one-fifth of the adult population in Bangladesh, even in a remote rural area, seem to be at risk of developing CVDs (25% of them at high risk and 25% at very high risk) within 10 years with males and females being almost equally vulnerable.

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DO - 10.1136/bmjopen-2015-008140

M3 - Article

VL - 5

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 10

M1 - e008140

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