Comparison Between ASCVD Versus WHO Risk Score in Predicting of 10-Year Cardiovascular Risk in an Iranian Adult: A Hospital-Based Cross-Sectional Study

Tolou Hasandokht; Arsalan Salari; Salman Nikfarjam; Soheil Soltanipour; Mani Shalchi; Alimohammad  Sadeghi Meibodi

doi:10.18502/acta.v60i1.8328

Tolou Hasandokht Cardiovascular Disease Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran
Arsalan Salari Cardiovascular Disease Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran
Salman Nikfarjam Cardiovascular Disease Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran
Soheil Soltanipour Department of Community Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Mani Shalchi Cardiovascular Disease Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran
Alimohammad Sadeghi Meibodi Cardiovascular Disease Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran

DOI: https://doi.org/10.18502/acta.v60i1.8328

Keywords: Cardiovascular disease; Risk assessment; Risk

Abstract

Cardiovascular disease (CVD) mortality has increased in the Iranian population. Word Health Organization (WHO) risk score was recently used in Iranian prevention and control of non-communicable disease programs for risk assessment. The purpose of the study was to compare the 10-year cardiovascular risk using atherosclerotic cardiovascular disease (ASCVD) and WHO risk score. In a cross-sectional study, data from patients with cardiac symptoms without any documents related to CVD were collected from the outpatient clinic. The proportion of subjects with high CVD risk according to ASCVD and WHO risk score and also agreement between two scores was presented. The sensitivity and specificity of ASCVD according to the WHO risk score as a national risk assessment tool were calculated. The study included 284 subjects with a mean age of 53.80 (8.78) years and 68 % of women. The frequency of subjects with high CVD risk based on ASCVD and WHO was 35% and 6%, respectively. The agreement between the two scores was moderate (κ=0.45), with the most agreement in identifying low-risk subjects. The sensitivity and specificity of ASCVD according to the WHO risk score was 95.3% and 75.1%, respectively. The present finding showed that Agreement between two risk scores was moderated, especially in stratifying low-risk subjects. But, the ASCVD risk score categorized more people as a high risk rather than the WHO tool. Assessment of the accuracy of the WHO risk score with comparing predicted risk with observed risk in a cohort study for the Iranian population is necessary.