|Year : 2016 | Volume
| Issue : 1 | Page : 3-4
Cardiovascular risk screening: Time for a wakeup call!
Department of Cardiology, King George Medical University, Lucknow, Uttar Pradesh, India
|Date of Web Publication||4-Mar-2016|
Department of Cardiology, King George Medical University, Lucknow, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Pradhan A. Cardiovascular risk screening: Time for a wakeup call!. Heart India 2016;4:3-4
Ischemic heart disease (IHD) is now ranked first among causes of mortality throughout the world beating stroke and infections. Between 1990 and 2010, the global burden of IHD has increased by 30% despite a decrease in the incidence of myocardial infarction and prevalence of angina. This was attributable primarily to an aging population and a lesser extent to population growth. Alarmingly, despite a declining trend in IHD mortality in developed countries, the South Asian region fared worse. Not only did the region have a maximum number of IHD deaths but the deaths occurred at a younger age too. To add to our woes, Yusuf et al. have described the under usage of drugs for secondary prevention of cardiovascular (CV) disease the problem being worse in low-income countries and rural areas. Indian data also mirror similar trends. The CREATE investigators described lower use of reperfusion therapy and guideline-directed medical therapy in IHD patients. Where do we go from here?
CV risk screening then becomes an integral part of IHD management armamentarium. It is an important tool for detection of high-risk IHD patients and implementation of measures to diminish the risk of future CV events. A lot of risk screening tools are in vogue but which one to choose? Framingham risk scoring system remains by far the most popular. However, it has got several limitations and systematically underestimates risk in South Asians including Indians., Only World Health Organization-International Society of Hypertension (WHO-ISH) risk prediction score and 3rd Joint British Societies-III (JBS-III) risk score have incorporated South Asian or Indian population and are relevant to us., Preliminary data suggest some evidence favoring JBS-III score.
In this issue of journal, authors report the use of WHO-ISH risk prediction chart in South Indian young population for assessment for CV risk. The authors reassuringly report a low incidence of diabetes, hypertension, and tobacco intake. However, around 2% of population (aged >40 years) had high 10 years CV risk despite the young age and negligible presence of conventional risk factors. These observations need to be confirmed in a larger patient population. This could be the tip of iceberg only. Gupta et al. recently described the higher prevalence of cardiometabolic risk factors in Indians and progressive rise in obesity, systolic blood pressure, and smoking over the years. The need of the hour is definitely to perform large and prospective studies for assessing CV risk in our population and to choose the ideal risk assessment tool. This will set the stage for research on various methods of risk reduction in next stage. A robust data on the prevalence of risk factors, CV risk and IHD burden in our population will enable us to convince ourselves and our peers about the need for routine risk assessment and implantation of relevant prevention strategies.
”What the mind does not know, the eyes cannot see.”
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Conflicts of interest
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