Cardiovascular Risk Assessment Varies Widely by Calculator and Race/Ethnicity in a Majority Latinx Cohort Living with HIV

J Immigr Minor Health. 2020 Apr;22(2):323-335. doi: 10.1007/s10903-019-00890-w.

Abstract

Comparison of cardiovascular disease (CVD) risk calculators in Latinx majority populations living with HIV can assist clinicians in selecting a calculator and interpreting results. 10-year CVD risks were estimated for 652 patients seen ≥ 2 times over 12 months in a public clinic using three risk calculators: Atherosclerotic CVD risk Calculator (ASCVD), Framingham Risk Calculator (FRC), and Data Collection on Adverse Effects of Anti-HIV Drugs Study (D:A:D) Calculator. Median estimated 10-year CVD risk in this population was highest using FRC (11%), followed by D:A:D (10%), and lowest with ASCVD (5%; p < 0.001). However, D:A:D classified 44.3% in a high/very high risk category compared to FRC (20.7%) and ASCVD (33.4%) (all p < 0.001). ASCVD risk estimates differed significantly by race/ethnicity (p < 0.001). Risk varied widely across three risk calculators and by race/ethnicity, and providers should be aware of these differences when choosing a calculator for use in majority minority populations.

Keywords: Cardiovascular risk; Cardiovascular risk calculation; Ethnicity; HIV; Hispanic; Race.

MeSH terms

  • Adult
  • Aged
  • Atherosclerosis / drug therapy
  • Cardiovascular Diseases / etiology*
  • Ethnicity
  • Female
  • HIV Infections* / drug therapy
  • Heart Disease Risk Factors*
  • Humans
  • Male
  • Middle Aged
  • Racial Groups*
  • Registries
  • Risk Assessment
  • Texas