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Eur J Prev Cardiol. 2019 Jun 1:2047487319853354. doi: 10.1177/2047487319853354. [Epub ahead of print]

Estimation of cardiovascular risk based on total cholesterol versus total cholesterol/high-density lipoprotein within different ethnic groups: The HELIUS study.

Author information

1
1 Department of Public Health, University of Amsterdam, The Netherlands.
2
2 Department of Cardiology, University of Amsterdam, The Netherlands.
3
3 Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, The Netherlands.

Abstract

AIMS:

European guidelines recommend estimating cardiovascular disease risk using the Systematic COronary Risk Evaluation (SCORE) algorithm. Two versions of SCORE are available: one based on the total cholesterol/high-density lipoprotein cholesterol ratio, and one based on total cholesterol alone. Cardiovascular risk classification between the two algorithms may differ, particularly among ethnic minority groups with a lipid profile different from the ethnic majority groups among whom the SCORE algorithms were validated. Thus in this study we determined whether discrepancies in cardiovascular risk classification between the two SCORE algorithms are more common in ethnic minority groups relative to the Dutch.

METHODS:

Using HELIUS study data (Amsterdam, The Netherlands), we obtained data from 7572 participants without self-reported prior cardiovascular disease of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan ethnic origin. For both SCORE algorithms, cardiovascular risk was estimated and used to categorise participants as low (<1%), medium (1-5%), high (5-10%) or very high (≥10%) risk. Odds of differential cardiovascular risk classification were determined by logistic regression analyses.

RESULTS:

The percentage of participants classified differently between the algorithms ranged from 8.7% to 12.4% among ethnic minority men versus 11.4% among Dutch men, and from 1.9% to 5.5% among ethnic minority women versus 6.2% among Dutch women. Relative to the Dutch, only Turkish and Moroccan women showed significantly different (lower) odds of differential cardiovascular risk classification.

CONCLUSION:

We found no indication that discrepancies in cardiovascular risk classification between the two SCORE algorithms are consistently more common in ethnic minority groups than among ethnic majority groups.

KEYWORDS:

HELIUS study; SCORE; cardiovascular risk estimation; cholesterol; ethnic groups; primary prevention

PMID:
31154827
DOI:
10.1177/2047487319853354

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