Agreement between the laboratory- and non-laboratory-based WHO cardiovascular risk charts: a cross-sectional analysis of a national health survey in Peru
File(s)
Published version
Author(s)
Guzman-Vilca, Wilmer Cristobal
Quispe-Villegas, Gustavo
Vascones Roman, Fritz Fidel
Bernabe-Ortiz, Antonio
Carrillo Larco, Rodrigo
Type
Journal Article
Abstract
Objective: To determine the agreement between the cardiovascular disease (CVD) risk predictions computed with the WHO non-laboratory-based model and laboratory-based model in a nationally representative sample of Peruvian adults.
Design: Cross-sectional analysis of a national health survey.
Methods: Absolute CVD risk was computed with the 2019 WHO laboratory-based and non-laboratory-based models. The risk predictions from both models were compared with Bland-Altman plots, Lin’s concordance coefficient correlation (LCCC), and kappa statistics, stratified by sex, age, body mass index categories, smoking and diabetes status.
Results: 663 people aged 30–59 years were included in the analysis. Overall, there were no substantial differences between the mean CVD risk computed with the laboratory-based model 2.0% (95% CI 1.8% to 2.2%) and the non-laboratory-based model 2.0% (95% CI 1.8% to 2.1%). In the Bland-Altman plots, the limits of agreement were the widest among people with diabetes (−0.21; 4.37) compared with people without diabetes (−1.17; 0.95). The lowest agreement as per the LCCC was also seen in people with diabetes (0.74 (95% CI 0.63 to 0.82)), the same was observed with the kappa statistic (kappa=0.36). In general, agreement between the scores was appropriate in terms of clinical significance.
Conclusions: The absolute cardiovascular predicted risk was similar between the laboratory-based and non-laboratory-based 2019 WHO cardiovascular risk models. Pending validation from longitudinal studies, the non-laboratory-based model (instead of the laboratory-based) could be used when assessing CVD risk in Peruvian population.
Design: Cross-sectional analysis of a national health survey.
Methods: Absolute CVD risk was computed with the 2019 WHO laboratory-based and non-laboratory-based models. The risk predictions from both models were compared with Bland-Altman plots, Lin’s concordance coefficient correlation (LCCC), and kappa statistics, stratified by sex, age, body mass index categories, smoking and diabetes status.
Results: 663 people aged 30–59 years were included in the analysis. Overall, there were no substantial differences between the mean CVD risk computed with the laboratory-based model 2.0% (95% CI 1.8% to 2.2%) and the non-laboratory-based model 2.0% (95% CI 1.8% to 2.1%). In the Bland-Altman plots, the limits of agreement were the widest among people with diabetes (−0.21; 4.37) compared with people without diabetes (−1.17; 0.95). The lowest agreement as per the LCCC was also seen in people with diabetes (0.74 (95% CI 0.63 to 0.82)), the same was observed with the kappa statistic (kappa=0.36). In general, agreement between the scores was appropriate in terms of clinical significance.
Conclusions: The absolute cardiovascular predicted risk was similar between the laboratory-based and non-laboratory-based 2019 WHO cardiovascular risk models. Pending validation from longitudinal studies, the non-laboratory-based model (instead of the laboratory-based) could be used when assessing CVD risk in Peruvian population.
Date Issued
2022-11-07
Date Acceptance
2022-10-10
Citation
BMJ Open, 2022, 12 (11)
ISSN
2044-6055
Publisher
BMJ Journals
Journal / Book Title
BMJ Open
Volume
12
Issue
11
Copyright Statement
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
License URL
Sponsor
Wellcome Trust
Grant Number
214185/Z/18/Z
Subjects
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
cardiac epidemiology
adult cardiology
epidemiology
BLOOD-PRESSURE
PREVENTION
adult cardiology
cardiac epidemiology
epidemiology
Adult
Humans
Cross-Sectional Studies
Cardiovascular Diseases
Peru
Risk Assessment
Risk Factors
Heart Disease Risk Factors
Diabetes Mellitus
Health Surveys
World Health Organization
Humans
Cardiovascular Diseases
Diabetes Mellitus
Health Surveys
Risk Assessment
Risk Factors
Cross-Sectional Studies
Adult
World Health Organization
Peru
Heart Disease Risk Factors
1103 Clinical Sciences
1117 Public Health and Health Services
1199 Other Medical and Health Sciences
Publication Status
Published
Article Number
ARTN e063289