世界卫生组织非实验室为基础的心血管疾病风险评估：在北印度人群中的可靠测量。
WHO Non-Lab-Based CVD Risk Assessment: A Reliable Measure in a North Indian Population.
机构信息
Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
Room. 14, Old OT block, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
出版信息
Glob Heart. 2022 Sep 1;17(1):64. doi: 10.5334/gh.1148. eCollection 2022.
INTRODUCTION
Timely, affordable, and sustained interventions reduce the risk of heart attack or Stroke in people with a high total risk of cardiovascular diseases (CVD). Risk prediction tools are available to estimate the cardiovascular risk using information on multiple variables. CVD risk charts prepared by the World Health Organization (WHO) has laboratory-based and non-laboratory-based charts with the latter meant for use in resource limited settings. We conducted a study to determine concordance between the laboratory- and non-laboratory risk charts and to estimate the prevalence of selected CVD risk factors in a rural Indian population.
METHODS
A community-based cross-sectional study was conducted in rural area of Ballabgarh in district Faridabad, Haryana. Sample of 1,018 participants aged 30-69 years was selected randomly from study area. Information on CVDs risk factors was obtained using WHO STEPS questionnaire, anthropometry and laboratory investigation. Risk distribution among the study participants was observed. Concordance between laboratory- and non-laboratory-based WHO CVD risk charts was determined using agreement analysis.
RESULTS
The mean age of the study participants was 43.9 (8.9) years and 55.6% participants were women. Among various CVD risk factors, hypertension (39.4%) was the major factor followed by overweight (34.1%) was found to be major factor, followed by current smoking (23.6%) and hypercholesterolemia (18.7%). The concordance between the two charts was 83.3% with kappa value of 0.64. Considering laboratory-based charts as the gold standard, the sensitivity and specificity of non-laboratory-based risk charts at 5% risk as cut-off was 86.5% and 90.3% respectively.
CONCLUSION
The study shows a good agreement between the laboratory-based and non-laboratory-based risk charts. Thus non-laboratory-based risk charts are suitable for risk estimation of CVDs for use in resource limited settings like India.
简介
及时、负担得起且可持续的干预措施可降低心血管疾病（CVD）高危人群发生心脏病发作或中风的风险。现已有风险预测工具可用于根据多个变量信息来评估心血管风险。世界卫生组织（WHO）制定的 CVD 风险图表有基于实验室和非实验室的图表，后者用于资源有限的环境。我们进行了一项研究，以确定实验室和非实验室风险图表之间的一致性，并估计印度农村人口中选定 CVD 风险因素的流行情况。
方法
在哈里亚纳邦法里达巴德区巴拉尔加的农村地区进行了一项基于社区的横断面研究。从研究区域中随机选择了 1018 名年龄在 30-69 岁的参与者。使用世卫组织 STEPS 问卷、人体测量和实验室检查获取 CVD 风险因素信息。观察研究参与者的风险分布。使用一致性分析确定实验室和非实验室的 WHO CVD 风险图表之间的一致性。
结果
研究参与者的平均年龄为 43.9（8.9）岁，55.6%的参与者为女性。在各种 CVD 风险因素中，高血压（39.4%）是主要因素，其次是超重（34.1%），其次是当前吸烟（23.6%）和高胆固醇血症（18.7%）。两种图表之间的一致性为 83.3%，kappa 值为 0.64。以实验室为基础的图表作为金标准，非实验室风险图表在 5%风险为切点时的灵敏度和特异性分别为 86.5%和 90.3%。
结论
该研究表明实验室和非实验室风险图表之间具有良好的一致性。因此，非实验室风险图表适合在印度等资源有限的环境中用于 CVD 风险评估。
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