World Health Organisation CVD risk charts updated using Cambridge-led research

Research revising the World Health Organisation (WHO) cardiovascular disease (CVD) risk prediction charts to aid efforts to reduce the burden of CVD, especially in low- and middle-income countries, has been published by The Lancet Global Health.

The research – carried out by the WHO CVD Risk Chart Working Group* and led by researchers at the University of Cambridge – was funded by the National Institute for Health Research Cambridge Biomedical Research Centre, WHO, British Heart Foundation (BHF), BHF Cambridge Centre for Research Excellence and UK Medical Research Council.

It analysed data from more than 375,000 mainly middle-aged participants in 85 prospective cohort studies to develop simplified risk prediction models and revised risk charts tailored for implementation in low- and middle- income countries. The participants did not have previous history of CVD at the outset and 19,000 had a CVD event (heart attack or stroke) during the first 10 years of follow up.

This risk models were then statistically adapted or ‘recalibrated’ to more accurately estimate CVD risk for contemporary populations in 21 global regions, using available estimates of population-specific CVD incidence rates and risk factor values, including low- and middle-income countries.

The revised risk models will help support these countries – which along with other WHO member states have committed to provide counselling and drug treatments for at least half of their populations known to be at high risk of CVD – in their efforts to prevent and control the disease.

Prof Emanuele Di Angelantonio, from the University of Cambridge, senior author of the study said: “Three-quarters of all premature deaths from CVD globally are in low- and middle-income countries and while there are many risk-prediction tools to help countries prevent and control CVD, they only apply to specific populations, usually in high-income countries.

“Our research ensures that the revised models are applicable to the circumstances of many different global regions, with a particular focus on low- and middle-income countries, where individual risk for CVD can vary hugely from region to region and resources may be limited.”

Dr Cherian Varghese, from WHO, which coordinated the study, said: “CVDs are the number 1 cause of death globally and more people die annually from CVDs than from any other cause. The use of updated CVD risk charts should enhance global efforts to prevent CVD worldwide and help to reduce premature mortality from non communicable diseases.”

*The WHO CVD Risk Chart Working Group is a global collaboration of academics, policy makers and end users and was convened to help develop tools for predicting CVD risk which could be used by low- and middle-income countries.

• “World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions” was published by The Lancet Global Health on 1 September 2019.
• CVD is one of the most common non-communicable diseases world-wide, responsible for an estimated 17.8 million deaths in 2017. It is a United Nations goal to cut premature deaths from non-communicable diseases (including CVD) by a third by 2030.