Abstract
Background: The accumulated knowledge on the development of cardiovascular disease in diabetic patients due to clustering and synergistic interaction of multiple risk factors leads to the establishment of cardiovascular disease 10-year risk prediction tools. The management of patients based on their total risk prediction is an effective way to reduce disease burden. The behavior of such tools varies based on population and their risk profile. Objective: To estimate the total 10-year cardiovascular disease risk using General Framingham Risk Prediction Score and World Health Organization /International Society for Hypertension (WHO/ISH) Risk Prediction Chart on Qatari diabetic patients. Methods: Cross-sectional design was used. A total of 532 Qatari diabetic patients attending primary healthcare were enrolled. Data were collected using an interview administered questionnaire, anthropometric & blood pressure measurement, and medical records. The total 10-year cardiovascular disease risk was assessed using the WHO/ISH risk prediction chart and Framingham score. Results: The former categorized (81.6%) of participants as low risk and only (3.8%) as in high and very high risk. While the later categorized (12.2%) of participants as low risk and (57.6%) as in high and very high risk. No agreement between both tools in assessment of cardiovascular disease risk (κ = - 0.019, p-value = 0.216). All risk factors used by both tools illustrated a statistically significant relation with risk categories, except ‘anti-hypertensive medications intake’ in the Framingham score. Conclusion: Encouraging assessment of patients based on total risk rather than single risk factor and further study of total risk prediction can help to establish a national tool for Qatar.
Highlights
Encouraging assessment of patients based on total risk rather than single risk factor and further study of total risk prediction can help to establish a national tool for Qatar
In the current study; despite of known highly prevalent Cardiovascular Disease (CVD) risk factors among Qatari patients with type 2 Diabetes Mellitus (DM), the WHO/International Society of Hypertension (WHO/ISH) CVD risk prediction chart showed that the majority of patients (81.6%) were drawn together in the ‘low risk’ category, while less than (4%) were grouped collectively in the ‘high’ and the ‘very high’ risk categories
The current study revealed that the WHO/ISH CVD risk prediction chart is toward categorizing more patients toward the low risk, while the General Framingham Risk Profile (GFRP) score is accumulating more patients toward the high and very high-risk category
Summary
The synergistic and multiplicative interactions between different risk factors of CVD in type 2 diabetic patients were well described This knowledge led to the development of multivariable risk prediction tools incorporating these risk factors, which have been simplified for use in the Primary Health Care (PHC) setting [5, 6]. The joint WHO/International Society of Hypertension (WHO/ISH) risk prediction charts and The General Framingham Risk Profile (GFRP) score for primary care are among the common tools used to assess 10-years total CVD risk. They use different age categories and risk factor profiles [7 - 9].
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