Cardiovascular Risk Screening Options in Diabetes: Framework for Selective Adoption

Abstract

Background: There exist several models for assessment of risk of cardiovascular disease (CVD), including different criteria for diag- nosis of obesity, of which a major disparity is ‘definition of waist circumference’. Case reports and comparative reviews are hereby presented to exemplify that one cap ‘model’ does not fit all. Cases: First case illustrates how very slim person with BMI of 17 may possess cardiovascular risk ≥22.7% compared to an obese in- dividual who has a BMI of 39 with CVD risk ≤8.0%. Second case review illustrates how the same BMI and lipid models vary in out- comes depending on gender. Third case report shows how differ- ent ‘definitions of waist circumference’ impacts on identification of obesity, which in turn affect decision about metabolic syndrome. Conclusion: The needs for paradigm shift and 5-step framework are briefly highlighted.

Keywords

• cardiovascular risk
• low-mid income communities
• screening models
• the 5As framework